Revolutionizing Digital Pain Management | MedPage Today

Revolutionizing Digital Pain Management | MedPage Today

June 17, 2022 0 By Jennifer Walker

In this video, Beth Darnall, PhD, of Stanford University’s Pain Relief Innovations Lab, discusses her research into the effectiveness of digital pain management interventions and their potential for improving equitable care and access.

The following is a transcript of her remarks:

In this study, we were examining the benefit of a brief digital pain education intervention that might help people recover from surgery with less pain. Most pain after surgery is treated with medications, and we want to deliver a whole-person pain care approach.

Our intervention is called “My Surgical Success” (MSS), and we compared MSS to a digital health education control group. We enrolled patients who were undergoing orthopedic trauma surgery at Stanford University. After orthopedic trauma surgery, patients often have quite a bit of pain that they can manage for months, and up to 10% of people have moderate to severe pain for 2 years later. So, having multimodal pain management approaches are really important.

We enrolled 84 patients undergoing orthopedic trauma surgery, randomized them either to MSS or our digital control intervention, and we followed them after surgery for 3 months to understand how our intervention might change pain intensity, as well as use of medication.

What we found was that people who were assigned to MSS had pretty good engagement rates with a fully digital treatment, which is important. Most importantly, we found that people in MSS reported reductions in pain proximal to the surgery and also durability of analgesia to 3 months later. Now, what we didn’t find was changes in opioid use. Opioid use after surgery remained the same in both treatment groups. But we feel that showing that people have reduced pain from a brief self-administered, on-demand intervention is a really nice result, suggesting that other programs might be able to implement this type of a program wherein behavioral health and pain management could be vastly more accessible than it is now.

This current study builds on prior work. We previously showed that when women undergoing breast cancer surgery receive MSS, we found that they needed less opioid medication after breast cancer surgery. So that was an interesting finding, and that combined with our new results where we show sustained analgesia after orthopedic trauma surgery really suggests that there’s true heterogeneity and treatment effects based on the surgical population.

There is much to be studied about how this intervention might impart therapeutic benefits across patients, across surgical populations, but we’re very excited for the future. I think one next step in this line of research might be applying for NIH funding to do broader and more extensive research to understand how these brief digital therapeutics could truly transform our ability to enhance recovery after surgery broadly.

Myself and my colleagues are very focused on digital health and digital interventions to improve access to evidence-based pain treatment. Historically, we have seen massive pain treatment disparities, and this was pre-existing before COVID, but COVID itself has only brought to light these disparities in treatment.

It also revealed an opportunity to better level the field to ensure equitable access to these evidence-based treatments — this whole-person pain care. So, It’s truly an exciting time to be able to envision how people all over the world might have ease of access to care from the comfort of their own home, whether that’s acute pain or chronic pain. And we have a whole portfolio of treatment options that are digitally-based and brief or single-session so that people can access the treatment that they need in the format that they want.

One of the greatest difficulties that we have been facing in pain care, whether that’s care of people with chronic pain or the care of individuals who have post-surgical pain, is that we do not have enough trained therapists and clinicians to meet the needs of varied populations and varied individual circumstances. This access issue has been pervasive over the past decades. We know what works and we talk a lot about efficacy, but without access, efficacy is meaningless.

What I love most about these brief single-session, digital interventions is that they transform the largest barrier that we have in pain care, in this behavioral pain care space, which is access. I’m personally excited for the future, because we’re bringing forward the evidence to truly transform how pain care is delivered.

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    Emily Hutto is an Associate Video Producer & Editor for MedPage Today. She is based in Manhattan.