For people with chronic pain taking long-term opioids, incorporating an internet-based self-management program into treatment may help reduce both pain and opioid intake, new research shows. It shows that
Pain is the most common reason people seek medical care and is a leading cause of disability, affecting over 30% of people worldwide. Chronic pain is defined as pain that persists or recurs for more than 3 months. About 50 million people in the United States have chronic pain, and about 18 million of them are prescribed long-term opioid therapy (LOT).
Problems associated with LOT are well known and include risks of abuse and misuse, drug resistance, physical dependence, respiratory depression, and accidental death. For these reasons, the Centers for Disease Control and Prevention (CDC) recommends that people reduce their opioid use and adopt alternative methods of managing pain, such as education, cognitive-behavioral therapy (CBT), and multidisciplinary rehabilitation. doing.
There are many studies supporting the use of self-management programs to improve pain and minimize disability. Internet-based (e-health) programs have been shown to provide an affordable and accessible way for people with chronic pain to access self-management tools, but they are less likely to benefit from reducing opioid use. There are no studies evaluating the effects of
A new study from Washington State University looks at how e-health programs affect long-term opioid therapy and chronic pain. About 400 participants who were prescribed LOT for pain were divided into his two groups.
The e-health program used, called the Goalistics Chronic Pain Management Program, was developed by a pain psychologist. Its content is presented through a mix of online and offline activities, including videos, symptom trackers, and downloadable worksheets. Additional content includes information on opioid tolerance and dependence, and non-opioid treatment options. All they needed for engagement was a phone and internet connection.
E-Health participants received weekly emails with program instructions and goals to complete the weekly activities. Participants completed self-report measures of opioid use throughout the study and rated pain on a 10-point scale. At the start of the study, all participants rated their pain on an average intensity of 5 or 6 out of 10, with 10 representing the most severe pain.
Researchers found that more than half (53.6%) of the participants given e-health access had reduced their opioid intake by 15% or more after six months, compared with 42.3% of controls. discovered.
Importantly, the study concluded that 14.5% of the e-health group reported a reduction in pain of 2 points or more. Only 6.8% of his control group participants reported a similar reduction in pain scores.
“These were very encouraging findings. Not only did the opioids decrease, but the pain did not worsen,” said Marian Wilson, the study’s lead author. “Some people are hesitant to stop taking opioids because they fear it will increase their pain, but we found that, at least on average in this population, we were able to reduce opioids a little and not experience any more pain symptoms. .”
Given the subjective nature of pain, researchers are interested in providing a self-monitoring program that can track pain levels and trying different pain management strategies to help self-monitor rather than provide quick solutions. It claims to give us more control over the state of
“The idea is to put the patient in the driver’s seat because you can give them a prescription for opioids, and that works for a while, but over time it becomes a solution to cure chronic pain.” No trouble,” said Wilson.
Additionally, the researchers say, e-health programs like the one used in this study address the mood, social and physical functioning issues that people with chronic pain often experience. .
The findings of this study provide further evidence for the benefits of self-management programs in the chronic pain setting.
Countries such as Canada and Australia offer similar e-health programs free of charge, but in the United States, access requires payment of a fee that most insurance companies do not cover. Researchers are currently working on a project aimed at expanding access for people in the United States.
The study was published in a journal pain.
Source: Washington State University
