In a recent clinical study, an online “e-health” programme assisted more people with chronic pain than a control group who solely got traditional treatment in reducing their opioid medication use and pain severity.
Almost 400 patients who had been given long-term opioid medication for chronic pain were split into two groups in the research that was published in the journal Pain. One group got standard care, while the other received standard care along with access to a self-directed, online health programme. At six months, 53.6% of patients in the e-health group were able to cut their opioid prescription by 15% or more, as opposed to 42.3% of patients in the control group.
“These were really positive results,” said Marian Wilson, an assistant professor of nursing at Washington State University and the study’s primary author. “Not only were they lowering opioids, but their pain was not getting worse.” According to the study, “we observed that at least on average in this group, individuals could lower their opioids a little bit without experiencing increasing pain symptoms.” Some patients are afraid to quit taking their opioid prescription because they think their pain would become worse.
Over 18 million Americans, out of the estimated 50 million who suffer from chronic pain, are given long-term opioid therapy. Researchers are looking for alternatives to aid these patients since there are hazards associated with using opioids, such as addiction and even accidental death.
All of the patients in this research initially reported their chronic pain as having an average severity of 5 or 6 on a scale of 0 to 10, with 10 being the most severe pain. The research participants had a variety of illnesses, including migraines, fibromyalgia, arthritis, back pain, and other disorders that might cause chronic pain.
14.5% of the participants in the e-health group said their pain had decreased by two points or more at the conclusion of the trial. Just 6.8% of those in the control group had the same reduction in pain. The researchers also noted that the patients’ understanding of pain, confidence in managing pain, and coping mechanisms had improved.
Goalistics Chronic Pain Management is an online health programme created by psychologists that was employed in this study. This self-paced course seeks to assist individuals in managing their personal pain and all of its effects on their daily life. Together with information on opioid usage and hazards, the programme includes a variety of pain monitoring tools, cognitive therapy, exercise suggestions, and relationship counselling.
According to Wilson, the software offers information that is comparable to what a patient may get from a pain psychologist—a kind of care that is not always readily available.
While there are other programmes that are comparable, the researchers picked this one since it is widely accessible in the US and entirely online. For the massive, randomised experiment in this study, Wilson previously tested the Goalistics programme in earlier research, which provided preliminary findings.
The authors contend that since everyone’s experience of pain is unique, patients may gain from self-management programmes that allow them to monitor their pain levels and try out various pain management techniques.
The objective is to put the patient in charge because, while we can write an opioid prescription for them, she said, “it’s typically not going to be the answer to cure all their problems for chronic pain.”
Wilson continued by saying that individuals with chronic pain often have problems with their moods, relationships, and physical health.
The results add to the growing body of research demonstrating the value of online self-management tools for people with chronic pain, and several organisations, including the Centers for Disease Control and Prevention, endorse their broad use.
The monthly cost of the e-health programme was $30 at the time of this research. These kinds of programmes are not covered by the majority of insurance in the United States, despite being relatively cheap in comparison to therapy by a pain psychologist. Similar services are offered to patients for free in other nations, including as Canada and Australia, and Wilson is now working on a project to increase access in the United States.
Rowena Dolor of Duke University, Daniel Lewis, Saundra Regan, Mary Beth Vonder Meulen, and T. John Winhusen of the University of Cincinnati are research co-authors in addition to Wilson. The National Institutes of Health’s National Institute on Substance Addiction provided funding for this research.
