Durable chronic low back pain reductions up to 24 months after treatment for an accessible, 8-week, in-home behavioral skills–based virtual reality program: a randomized controlled trial

Maddox, Todd; Sparks, C.; Oldstone, Liesl; Maddox, Roselani; Ffrench, Kelsey; Garcia, Heidy; Krishnamurthy, Parthasarathy; Okhotin, David; García, Laura Martínez; Birckhead, Brandon; Sackman, Josh; Mackey, Ian; Louis, Robert G.; Salmasi, Vafi; Oyao, Alexis; Darnall, Beth D.

doi:10.1093/pm/pnad070

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…Beyond mHealth eLearning solutions, patients with chronic pain may be further helped through advanced behavior change interventions supported by mHealth and via digital therapeutics such as augmented and virtual reality-based psychology and mindfulness training. 31 , 32 Despite growing evidence of the helpfulness of mHealth solutions for clinical care, and the growing interests on behalf of both patients and providers, little guidance exists into how to best incorporate this new class of tools into routine clinical care.…”

Section: Discussionmentioning

confidence: 99%

Implementation of eLearning solutions for patients with chronic pain conditions

Philpot,

Ahrens,

Eastman

et al. 2023

DIGITAL HEALTH

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Background Digital and mobile (mHealth) solutions are online or application-based services intended to support individuals with health needs. Despite evidence supporting the use of mHealth for patients with chronic pain, and the increasing desire of these types of solutions by both patients and providers, adoption of mHealth solutions remains limited. Implementation mapping can serve as a practical method to facilitate implementation and adoption of mHealth solutions within healthcare settings. Methods Implementation mapping was used to develop implementation strategies based on contextual determinants organized within the Consolidated Framework for Implementation Research (CFIR) for mHealth eLearning solutions across an integrated, multi-site healthcare system. We describe our experience identifying stakeholders, delineating implementation facilitators and barriers, defining implementation outcomes using RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, outlining initial implementation strategies, and iterating on implementation strategies. Results A total of 30 implementation strategies were identified and implemented. Over the first year, primary and specialty care providers across all the clinical sites ( n = 70) placed 2559 orders for the mHealth solution. Most patients reported receiving the mHealth eLearning module (74%), and most patients felt that the tool improved their knowledge regarding their condition (82%) and their ability to provide self-care related to the condition (73%). Conclusion Practical applications of implementation science methods can help enable change within healthcare settings. Implementation mapping is an exercise that can engage stakeholders to facilitate the incorporation of new methods of care delivery, including mHealth solutions.

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Section: Discussionmentioning

confidence: 99%

Implementation of eLearning solutions for patients with chronic pain conditions

Philpot,

Ahrens,

Eastman

et al. 2023

DIGITAL HEALTH

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show abstract

“…PDT, prescription digital therapeutic; OTC, over-the-counter; AI, artificial intelligence. Products Type of Product Healthcare Outcomes References RelieVRx FDA-cleared virtual reality system as PDT intended for treatment of chronic low back pain Long-term, non-opioid pain reduction in adults with moderate to severe chronic low back pain [ 39 , 55 , 56 , 57 ] Welldoc App, BlueStar FDA-cleared PDT and OTC DTx mobile apps that provide support and digital coaching for patients with diabetes, prediabetes, heart failure, and hypertension Diabetic patients experienced a statistically significant improvement in hemoglobin A1c levels [ 58 , 59 ] EndeavorOTC, EndeavorRx OTC DTx and PDT mobile game designed to treat and improve attention deficit hyperactivity disorder (ADHD) symptoms in children and adults using a series of video games Improvements in attention, multi-tasking, and cognitive function for adults with ADHD. PDT version was also effective for pediatric ADHD [ 41 , 60 , 61 ] Daylight by Big Health CBT-based mobile app marketed for generalized anxiety disorder under the FDA enforcement discretion Long-lasting improvement of generalized anxiety [ 62 , 63 ] Sleepio Digital CBTi intervention for insomnia marketed under FDA enforcement discretion Improves irregular sleeping patterns.…”

Section: Digital Health Technologies For Improving Healthcare Outcomesmentioning

confidence: 99%

Redesigning Pharmacy to Improve Public Health Outcomes: Expanding Retail Spaces for Digital Therapeutics to Replace Consumer Products That Increase Mortality and Morbidity Risks

Bulaj,

Coleman,

Johansen

et al. 2024

Pharmacy

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United States healthcare outcomes, including avoidable mortality rates, are among the worst of high-income countries despite the highest healthcare spending per capita. While community pharmacies contribute to chronic disease management and preventive medicine, they also offer consumer products that increase mortality risks and the prevalence of cardiovascular diseases, diabetes, cancer, and depression. To resolve these contradictions, our perspective article describes opportunities for major pharmacy chains (e.g., CVS Pharmacy and Walgreens) to introduce digital health aisles dedicated to prescription and over-the-counter digital therapeutics (DTx), together with mobile apps and wearables that support disease self-management, wellness, and well-being. We provide an evidence-based rationale for digital health aisles to replace spaces devoted to sugar-sweetened beverages and other unhealthy commodities (alcohol, tobacco) that may increase risks for premature death. We discuss how digital health aisles can serve as marketing and patient education resources, informing customers about commercially available DTx and other technologies that support healthy lifestyles. Since pharmacy practice requires symbiotic balancing between profit margins and patient-centered, value-based care, replacing health-harming products with health-promoting technologies could positively impact prevention of chronic diseases, as well as the physical and mental health of patients and caregivers who visit neighborhood pharmacies in order to pick up medicines.

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The Role of Virtual Reality in the Management of Irritable Bowel Syndrome

Suchak,

Almario,

Liran

et al. 2024

Curr Gastroenterol Rep

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Purpose of Review Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that significantly impacts health-related quality of life (HRQOL). This article explores the potential role of virtual reality (VR)-based cognitive behavioral therapy (CBT) in treating patients with IBS. Recent Findings While CBT is a proven, skills-based therapy approach that modifies behaviors and alters dysfunctional thinking patterns to influence the gut-brain axis and improve IBS symptoms, it is rarely prescribed given a paucity of CBT-trained clinicians. We developed a novel VR program that delivers a standardized CBT program over an 8-week period to help patients manage their symptoms. In initial qualitative validation testing, patients expressed positive perceptions about using VR CBT for IBS. Summary Home-based, standardized VR CBT has the potential to be an effective and scalable treatment option for patients with IBS. While initial studies have shown proof-of-concept definitive randomized controlled trials are needed to demonstrate the efficacy of self-administered VR CBT in IBS.

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Durable chronic low back pain reductions up to 24 months after treatment for an accessible, 8-week, in-home behavioral skills–based virtual reality program: a randomized controlled trial

Abstract: Trial Registration Information ClinicalTrials.gov NCT04415177; https://clinicaltrials.gov/ct2/show/NCT04415177 International Registered Report Identifier (IRRID) RR2-10.2196/25291

Cited by 9 publications

References 7 publications

Implementation of eLearning solutions for patients with chronic pain conditions

Implementation of eLearning solutions for patients with chronic pain conditions

Redesigning Pharmacy to Improve Public Health Outcomes: Expanding Retail Spaces for Digital Therapeutics to Replace Consumer Products That Increase Mortality and Morbidity Risks

The Role of Virtual Reality in the Management of Irritable Bowel Syndrome

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