An interactive Web-based resource that offers self-care tools, meditation, yoga, and nutritional guidance and includes group medical visits reduces chronic pain in patients with little or no access to in-person therapies, new research shows.
Using conventional pharmacologic therapies, most patients report only modest or moderate pain relief at best. Patients of lower socioeconomic status (SES) may have difficulty accessing any pain therapies because of financial and logistical factors, Paula Gardiner, MD, associate professor, University of Massachusetts Medical School, and director, Medical Group Visit Program, told
delegates attending the Academy of Integrative Pain Management (AIPM) Inaugural Global Pain Clinician Summit 2018.
The Our Whole Lives (OWL) pain management platform provides online materials for integrative medical group visits. Such materials include videos featuring clinician-led talks on pain control, stress, insomnia, obesity, depression, nutrition, and goal setting.
Patients are introduced to self-massage techniques, acupressure, and healthy cooking. They’re encouraged to track their vital signs and health goals and to participate in a monitored discussion group with peers.
Each group includes 10 to 15 patients and two facilitators (typically a nurse practitioner, MD, or physician assistant who is a prescriber) as well as a cofacilitator, such as a community health worker. Groups discuss topics such as physical activity, lifestyle changes, mindfulness, and psychological problems.
Patients can access OWL using a computer or smartphone.
The OWL website is interactive. Patients can log the number of hours of yoga they perform at home and support one another online. There is also a “virtual” patient advocate.
For the study, investigators reached out to primary care providers in the Boston area for referrals and recruited patients from area community health centers.
The study included 43 adult patients (mean age, 50.4 years; 91% women; 37% black; 30% white). About 26% had a yearly household income of $10,000 or less.
For a period of at least 3 months, study participants self-reported chronic pain (extremity, joint, back, or neck) in which the average pain intensity for the previous week was greater than 4 on a 0 to 10 numerical rating scale.
Almost three quarters of the participants (74%) were taking medications; 44% were taking opioids, and 51% were taking a nonsteroidal anti-inflammatory drug (NSAID).
Pain Med Use Reduction
At study outset, participants were oriented to the OWL program. They were taught how to log onto the system, navigate through the various sessions, complete self-assessments, set goals, and interact on the community page.