Digital Care for Chronic Musculoskeletal Pain: 10,000 Participant Longitudinal Cohort Study

Bailey, Jeannie F.; Agarwal, Vibhu; Zheng, Patricia; Smuck, Matthew; Fredericson, Michael; Kennedy, David J.; Krauss, Jeffrey

doi:10.2196/18250

Cited by 83 publications

(118 citation statements)

References 46 publications

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“…(2020) 32 UK Telephone and video both 1359∗ - telephone 133∗ - videoconference 90% patients satisfied with telephone 85% for video Orthopedic patients with varying issues NR Bailey JF et al. (2020) 33 USA Digital program with an app, videoconference and phone calls 6468 back pain 3796 knee pain Final satisfaction score - 8.97 out of 10 Followup patients with knee and back pain NR Current study India Telephone 450 92% patient satisfied with telemedicine Multiple orthopedic issues 28.57% NR = not reported, ∗ Final assessment. …”

Section: Discussionmentioning

confidence: 99%

Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study

Kumar¹,

Kumar²,

Kumar³

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Background: The current COVID-19 pandemic has implications on the morbidities of orthopedic patients due to lack of routine follow-ups, and inpatient and outpatient-based interventions. Telemedicine has recently emerged as an alternative for healthcare delivery to the patients and providing them with important information about orthopedic self-care and medications that can be followed without a hospital visit. However, due to lack of physical assessment, telemedicine is bound to have some limitations as well. The aim of this study is to analyze the effectiveness of proactive telemedicine in maintaining follow-up of orthopedic patients, and their satisfaction with telemedicine as an alternative mode of treatment delivery. Methods: This one-month cross-sectional study enrolled the follow-up patients that visited the orthopedic outpatient-department in February 2020. The patients were sequentially called according to the order of their registration, on a daily basis. Consenting patients were provided with telemedicine-based consultations, and those requiring physical evaluation were called for outpatient visits after documenting the valid reasons. The response-rates and the volume of patients requiring physical visits were measured for different diagnosis-based groups. Patients were asked to complete a questionnaire that included overall patient satisfaction with telemedicine, its effectiveness, and ease in following the telemedicinebased treatment. Results: The response rate to telemedicine was 88.67%. Among the patients availing telemedicine, 71.43% were managed without needing physical visits to the outpatient-department. The need for physical examination and failed patient-doctor communication were the most common reasons for advising physical outpatient visits. The overall satisfaction-rate to telemedicine was 92%, and only 7.2% of patients had difficulty in understanding or following telemedicine-based advice. Conclusions: Telemedicine can effectively reduce the need for physical visits to outpatient-departments for follow up of orthopedic patients. The response-rate and overall patient-satisfaction rates to telemedicine are high. Further efforts in expanding the use of telemedicine and addressing its limitations, especially those related to the failed communications, are needed to develop it as an alternative to physical orthopedic consultations in the current situation.

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Section: Discussionmentioning

confidence: 99%

Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study

Kumar¹,

Kumar²,

Kumar³

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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“…Most of these articles have focused on the challenges and terminology, or different telehealth or eHealth tools. There are also a number of articles that address specific subgroups of patients with spinal disorders such as low back pain [ 31 ], general musculoskeletal disorders [ 7 , 10 , 32 , 33 ], and inflammatory joint diseases [ 34 ], as well as triage of surgical patients [ 3 ]. Many of the articles addressing spine care during COVID-19 make recommendations based on a single or unspecified guideline [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is early evidence that telehealth [ 39 ] or digital care can have a positive impact on low back pain [ 39 - 41 ] and that these modalities are well accepted by patients, at least in conjunction with in-person access to a clinician when needed. The more general use of an app to educate patients with musculoskeletal pain is also being explored [ 32 ]. This is becoming more feasible with the extensive and increasing availability of access to mobile phones in many low- and middle-income countries [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Distance Management of Spinal Disorders During the COVID-19 Pandemic and Beyond: Evidence-Based Patient and Clinician Guides From the Global Spine Care Initiative

Haldeman¹,

Nordin²,

Tavares³

et al. 2021

JMIR Public Health Surveill

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Background The COVID-19 pandemic has greatly limited patients' access to care for spine-related symptoms and disorders. However, physical distancing between clinicians and patients with spine-related symptoms is not solely limited to restrictions imposed by pandemic-related lockdowns. In most low- and middle-income countries, as well as many underserved marginalized communities in high-income countries, there is little to no access to clinicians trained in evidence-based care for people experiencing spinal pain. Objective The aim of this study is to describe the development and present the components of evidence-based patient and clinician guides for the management of spinal disorders where in-person care is not available. Methods Ultimately, two sets of guides were developed (one for patients and one for clinicians) by extracting information from the published Global Spine Care Initiative (GSCI) papers. An international, interprofessional team of 29 participants from 10 countries on 4 continents participated. The team included practitioners in family medicine, neurology, physiatry, rheumatology, psychology, chiropractic, physical therapy, and yoga, as well as epidemiologists, research methodologists, and laypeople. The participants were invited to review, edit, and comment on the guides in an open iterative consensus process. Results The Patient Guide is a simple 2-step process. The first step describes the nature of the symptoms or concerns. The second step provides information that a patient can use when considering self-care, determining whether to contact a clinician, or considering seeking emergency care. The Clinician Guide is a 5-step process: (1) Obtain and document patient demographics, location of primary clinical symptoms, and psychosocial information. (2) Review the symptoms noted in the patient guide. (3) Determine the GSCI classification of the patient’s spine-related complaints. (4) Ask additional questions to determine the GSCI subclassification of the symptom pattern. (5) Consider appropriate treatment interventions. Conclusions The Patient and Clinician Guides are designed to be sufficiently clear to be useful to all patients and clinicians, irrespective of their location, education, professional qualifications, and experience. However, they are comprehensive enough to provide guidance on the management of all spine-related symptoms or disorders, including triage for serious and specific diseases. They are consistent with widely accepted evidence-based clinical practice guidelines. They also allow for adequate documentation and medical record keeping. These guides should be of value during periods of government-mandated physical or social distancing due to infectious diseases, such as during the COVID-19 pandemic. They should also be of value in underserved communities in high-, middle-, and low-income countries where there is a dearth of accessible trained spine care clinicians. These guides have the potential to reduce the overutilization of unnecessary and expensive interventions while empowering patients to self-manage uncomplicated spinal pain with the assistance of their clinician, either through direct in-person consultation or via telehealth communication.

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“…These modalities will undoubtedly continue to increase in popularity because of demand and current restrictions on elective in-person visits. 5 , 7 , 20 , 26 , 32 …”

Section: What Practicing Surgeons Are Doing Nowmentioning

confidence: 99%

A new role for orthopaedic surgeons: ongoing changes, lessons learned, and perspectives from a level I trauma center during the COVID-19 pandemic

Congiusta

Otero

Ippolito

et al. 2020

Journal of Shoulder and Elbow Surgery

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The COVID-19 pandemic has redefined global health care. With almost 13 million confirmed cases worldwide, medical professionals have been forced to modify their practice to take care of an expanded, critically ill population. Institutions have been challenged to implement innovative ways to maximize the utility and the safety of residents and personnel. Guided by lessons learned from prior mass causalities, wars, and previous pandemics, adjustments have been made in order to provide optimal care for all patients while still protecting limited resources and the lives of health care workers. Specialists who are trained in the management of lethal aspects of this disease continue to have a high demand and obvious role. Orthopedic surgeons, with ill-defined roles, have been redeployed to manage complex medical problems. Still, the need to manage trauma, fractures, infections, tumors, and dislocations remains a necessity. Various innovative measures have been taken to maximize the utility and safety of residents in the inpatient and outpatient setting. Commonalities to most measures and distinct changes in practice philosophy can be identified and applied to both current and future pandemic responses.

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Digital Care for Chronic Musculoskeletal Pain: 10,000 Participant Longitudinal Cohort Study

Cited by 83 publications

References 46 publications

Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study

Feasibility of telemedicine in maintaining follow-up of orthopaedic patients and their satisfaction: A preliminary study

Distance Management of Spinal Disorders During the COVID-19 Pandemic and Beyond: Evidence-Based Patient and Clinician Guides From the Global Spine Care Initiative

A new role for orthopaedic surgeons: ongoing changes, lessons learned, and perspectives from a level I trauma center during the COVID-19 pandemic

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