Telecare Intervention Improves Chronic Pain: Study | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Telecare Intervention Improves Chronic Pain: Study

July 15, 2014
by John DeGaspari
| Reprints
Recent movement toward reimbursement for telehealth and between-visit care may make telecare for pain management more attractive to primary care practices, according to the researchers

A telephone-delivered intervention, which included automated symptom monitoring, produced clinically meaningful improvements in chronic musculoskeletal pain compared to usual care, according to a study in the July 16 issue of JAMA.

Pain is the most common symptom reported both in the general population and patients seen in primary care, the leading cause of work disability, and a condition that costs the United States more than $600 billion each year in health care and lost productivity. Telemedicine strategies for pain care have been proposed but not rigorously tested to date, according to background information in the article.

Kurt Kroenke, M.D., of Roudebush VA Medical Center, Indiana University School of Medicine, and the Regenstrief Institute, Indianapolis, and colleagues randomly assigned 250 patients with chronic musculoskeletal pain to an intervention group or to a usual care group whose members received all pain care as usual from their primary care physicians. The intervention group received 12 months of telecare management that included automated symptom monitoring with an algorithm-guided approach to optimizing pain medications.

Among the key results of the trial:

  • Patients in the intervention group were nearly twice as likely to report at least a 30 percent improvement in their pain score by 12 months (51.7 percent versus 27.1 percent);
  • The intervention was associated with clinically meaningful improvements in pain and a greater rate of improvement (56 percent versus 31 percent);
  • Patients in the usual care group were almost twice as likely to experience worsening of pain by 6 months compared with those in the intervention group (36 percent versus 19 percent);
  • Few patients in either group were started on opioids or had escalations in their opioid dose during the study period; and
  • Patients in the intervention group were also more likely to rate as good to excellent the medication prescribed for their pain (73.9 percent versus 50.9 percent) as well as the overall treatment of their pain (76.7 percent versus 51.6 percent).

“The intervention was effective, even though most trial participants reported pain that had been present for many years, that involved multiple sites, and that had been unsuccessfully treated with numerous analgesics,” according to the authors in a prepared statement. “The improvement in pain with minimal opioid initiation or dose escalation is noteworthy, given increasing concerns about the consequences of long-term opioid use.”

The researchers add that the results of this trial, along with findings from a previous trial conducted among patients with cancer, show that algorithm-guided optimization of pain medication can be efficiently delivered through a predominantly telephone and Internet-based approach.

 

Topics

News

NewYork-Presbyterian, Walgreens Partner on Telemedicine Initiative

NewYork-Presbyterian and Walgreens are collaborating to bring expanded access to NewYork-Presbyterian’s healthcare through new telemedicine services, the two organizations announced this week.

ONC Releases Patient Demographic Data Quality Framework

The Office of the National Coordinator for Health IT (ONC) developed a framework to help health systems, large practices, health information exchanges and payers to improve their patient demographic data quality.

AMIA, Pew Urge Congress to Ensure ONC has Funding to Implement Cures Provisions

The Pew Charitable Trusts and the American Medical Informatics Association (AMIA) have sent a letter to congressional appropriators urging them to ensure that ONC has adequate funding to implement certain 21st Century Cures Act provisions.

Former Michigan Governor to Serve as Chair of DRIVE Health

Former Michigan Governor John Engler will serve as chair of the DRIVE Health Initiative, a campaign aimed at accelerating the U.S. health system's transition to value-based care.

NJ Medical Group Launches Statewide HIE, OneHealth New Jersey

The Medical Society of New Jersey (MSNJ) recently launched OneHealth New Jersey, a statewide health information exchange (HIE) that is now live.

Survey: 70% of Providers Using Off-Premises Computing for Some Applications

A survey conducted by KLAS Research found that 70 percent of healthcare organizations have moved at least some applications or IT infrastructure off-premises.