Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

Darnall, Beth D.; Edwards, Karlyn A.; Courtney, Rena E.; Ziadni, Maisa S.; Simons, Laura E.; Harrison, Lauren E.

doi:10.3389/fpain.2023.1223172

Cited by 3 publications

(1 citation statement)

References 92 publications

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“…Additional resources are also available; Darnall et al reviewed several promising education and treatment technology innovations to improve access and scalability of evidence-based behavioral pain treatments ( 214 ). Identifying risk and protective factors early, in primary care if possible, might also shift the balance of perpetuating factors to palliating and protective factors to promote recovery.…”

Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Interstitial cystitis (IC) presents as a chronic pain condition with variable combinations of symptoms depending on the species and individual patient. It is diagnosed by the presence of lower urinary tract signs and symptoms in combination with a variety of comorbid health problems, a history of life adversities, and the absence of other conditions that could cause the lower urinary tract signs. IC occurs naturally in humans and cats as a dimensional condition, with patients presenting with mild, moderate, and severe symptoms. Most patients appear to recover without specific treatment. A number of rodent models of IC have been used to study its causes and treatments. Unfortunately, current therapies generally fail to ameliorate IC symptoms long-term. The recent classification of IC as a chronic primary pain disorder calls for a rethinking of current clinical and research approaches to it. Beginning when a patient encounters a clinician, precipitating, perpetuating, and palliating risk factors can be addressed until a cause or reliably effective therapy is identified, and identifying predisposing and preventive factors can inform epidemiological studies and health promotion interventions. Predisposing, precipitating, and perpetuating risk factors, including environmental, psychological, and biological, increase the activity of the central threat response system (CTRS), which plays a clinically important role in IC symptoms. Studies in cats and rodent models have revealed that environmental enrichment (EE), in the absence of bladder-directed therapies, leads to amelioration of IC symptoms, implying a central role for the CTRS in symptom precipitation and perpetuation. Conceptually moving the source of IC pain to the brain as a motivational state rather than one resulting from peripheral nociceptive input offers both clinicians and researchers novel opportunities to improve care for patients with IC and for researchers to use more ecologically valid rodent models. It may even be that IC results from an excess of risk to protective factors, making this imbalance a targetable cause rather than a consequence of IC.

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Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Scratching the surface: the complex interface of chronic pain and mental health treatment needs in the United States

Sturgeon,

Ziadni,

Trost

et al. 2024

Pain

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Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases

Biskupiak,

Ha,

Rohaj

et al. 2024

JCM

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Limitations of pharmaceutical drugs and biologics for chronic diseases (e.g., medication non-adherence, adverse effects, toxicity, or inadequate efficacy) can be mitigated by mobile medical apps, known as digital therapeutics (DTx). Authorization of adjunct DTx by the US Food and Drug Administration and draft guidelines on “prescription drug use-related software” illustrate opportunities to create drug + digital combination therapies, ultimately leading towards drug–device combination products (DTx has a status of medical devices). Digital interventions (mobile, web-based, virtual reality, and video game applications) demonstrate clinically meaningful benefits for people living with Alzheimer’s disease, dementia, rheumatoid arthritis, cancer, chronic pain, epilepsy, depression, and anxiety. In the respective animal disease models, preclinical studies on environmental enrichment and other non-pharmacological modalities (physical activity, social interactions, learning, and music) as surrogates for DTx “active ingredients” also show improved outcomes. In this narrative review, we discuss how drug + digital combination therapies can impact translational research, drug discovery and development, generic drug repurposing, and gene therapies. Market-driven incentives to create drug–device combination products are illustrated by Humira® (adalimumab) facing a “patent-cliff” competition with cheaper and more effective biosimilars seamlessly integrated with DTx. In conclusion, pharma and biotech companies, patients, and healthcare professionals will benefit from accelerating integration of digital interventions with pharmacotherapies.

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Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

Cited by 3 publications

References 92 publications

Interstitial cystitis—an imbalance of risk and protective factors?

Interstitial cystitis—an imbalance of risk and protective factors?

Scratching the surface: the complex interface of chronic pain and mental health treatment needs in the United States

Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases

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