Telehealth monitoring can reduce chronic pain, opioid use

Telehealth services can help primary care physicians reduce chronic pain through better monitoring and reduced opioid use, according to a study in the Journal of the American Medical Association (JAMA).

The study followed patients from five primary care clinics who reported moderate-intensity musculoskeletal pain, including low back, neck and joint pain, and generalized, chronic pain. Of the 250 patients selected for the study, half received normal care and half received a year of telephone monitoring along with standard care. Patients who received telephone monitoring were twice as likely to report 30% less pain after 12 months. Researches also noted that fewer telehealth patients started taking or escalated doses of opioids.

“The use of opioids in chronic pain is increasingly questioned because of uncertainty about whether harms outweigh benefits,” the researchers say. “The improvement in pain with minimal opioid initiation or dose escalation is noteworthy, given increasing concerns about the consequences of long-term opioid use.”

Pain is the top complaint that primary care physicians hear, and costs $600 billion in healthcare and lost productivity annually, according to the study. Nearly 70 million doctor visits a year are attributed to pain management.

“Only a few trials enhancing pain management in primary care have been published, and these have focused on behavioral interventions rather than optimizing analgesic therapy,” the study’s authors say. “Telemedicine strategies for pain care have been proposed but not rigorously tested to date.”

Telehealth is expected to reach 7 million people worldwide by 2018, and is expected to help physicians manage patients with chronic conditions who have more difficulty gaining access to managed care and specialists, according to an IHS Technology report released in January.