- Geisinger Health System patients enrolled in an mHealth study on pain management are using wearables “consistently and frequently” to document their care, according to an interim analysis released this week.
“We are encouraged by these interim data and pleased to report that adding wearable health technology to our Multidisciplinary Pain Program has been well received by patients and, furthermore, has increased communication between providers and patients,” said John J. Han, MD, director of the Pennsylvania health system’s Department of Pain Medicine, in a press release.
“The integration of wearable health technology augments the assessments conducted in clinic with patient-reported data,” he added. “The additional data seem to be supporting more robust interactions between doctors, clinic staff, and patients compared to what we’ve seen when patients rely on memory to describe their pain between clinic visits.”
Study-co-authors Han and Thomas Alfieri, PhD, director of Medical Affairs Strategic Research for Purdue Pharma, presented the interim analysis this week at the 12th Annual PAINWeek Conference, currently underway in Las Vegas.
Launched in October 2017 by Geisinger and Purdue Pharma, the year-long study is designed to “assess the effect of the addition of WHT on patient and health system outcomes within a multidisciplinary pain program for patients with chronic pain.” Participants are asked to measure and report pain scores and breakthrough pain, medication use, depression, physical activity, heart rate and sleep quality through an Apple Watch and a specially designed Pain Watch app on their iPhone. Through the app, they are guided on non-pharmaceutical treatment alternatives such as stretching, mindfulness and thermotherapy.
The data transmitted by patients is fed into Geisinger’s electronic health record. A customizable dashboard allows providers to review patient-entered data and collaborate with patients on care management and coordination.
The results of the WHT group are being compared against a control group of 240 patient who are receiving in-person treatment at the same time, as well as a second control group of 150 patients who completed their care program prior to the study’s launch.
“We are incorporating advanced technology into the traditional healthcare setting to redirect and empower the patient to take more control of their own well-being,” Han said in the press release announcing the study’s launch. “The proposed multi-level integrated platform will facilitate and accelerate the speed of communication between the patient and healthcare providers, thereby allowing quicker patient access to appropriate care. Furthermore, it is hoped providing more education as well as alternative, non-opioid treatment options and coaching to promote a long-term sustainable healthy lifestyle will improve patient function and quality of life.”
According to data gathered on the first 55 patients enrolled in the program, a little more than two-thirds regularly accessed the Pain App, and roughly 54 percent entered sleep data.
At least half of the days with pain score entries, meanwhile, included as many as four body parts with end-of-day pain scores and five breakthrough pain scores. And almost all of the participants recorded stretching, mindfulness and hot/cold therapy to augment their pain management, with many applying various modalities multiple times per day.
In a detailed examination of a subgroup of patients with at least four months of data, researchers calculated average pain scores for the group and found that:
- When breakthrough pain was recorded, patients typically recorded multiple breakthrough pain scores for various painful areas on the body; 67 percent of days had multiple entries;
- The average breakthrough pain score was 5.4 out of 10;
- Use of breakthrough medication was logged on 28.7 percent of study days;
- Use of alternative therapies was recorded on 42.9 percent of study days; and
- Sleep patterns were recorded on 38.5 percent of study days (59.4 percent of days among those using mHealth wearables).
Researchers also want to assess whether the study participants show “statistically significant improvements over time related to sleep (number of hours and number of restful hours), activity level (steps, minutes of exercise) and daily pain scores.”
“We’re pleased to see patients benefiting from the technology, reporting increased engagement with providers with additional emphasis on alternative therapies, activity levels, and sleep quality,” Alfieri said in the press release. “We believe there is a strong potential for wearable health technology to be used by patients with chronic pain and other chronic conditions, and this analysis provides important information that will inform the use of such technologies in the future.”