A new study published in JAMA reveals that a telephone-delivered intervention, which included automated symptom monitoring, produced clinically meaningful improvements in chronic musculoskeletal pain compared to usual care, according to a Newswise news report. Kurt Kroenke, MD, and colleagues randomly assigned 250 patients with chronic musculoskeletal pain to an intervention group (n=124) or to a standard care group whose members received all pain care as usual from their primary care physician (n=126). The intervention group received 12 months of telecare management.
The telecare management included automated symptom monitoring with an algorithm-guided approach to optimizing pain medications. The Newswise news report notes that two of the key results of the trial included patients in the intervention group were almost twice as likely to report at least a 30% improvement in their pain score by 12 months and the intervention was associated with clinically meaningful improvements in pain and a greater rate of improvement.
In addition, 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 and few patients in either group were started on opioids or had escalations in their opioid dose during the study period. The Newswise news report indicates that patients in the intervention group were also more likely to rate as good to excellent the medication prescribed for their pain (73.9% vs 50.9%) as well as the overall treatment of their pain (76.7% vs 51.6%).
The authors of the study write, “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. The improvement in pain with minimal opioid initiation or dose escalation is noteworthy, given increasing concerns about the consequences of long-term opioid use.”
As indicated on the Newswise news report, the researchers note that the results of this trial along with findings from a previous study conducted with patients with cancer show that algorithm-guided optimization of pain medication can be efficiently delivered through a predominantly telephone and Internet-based approach.
Sources: Newswise, JAMA