Telemedicine for chronic pain treatment during the COVID‐19 pandemic: Do pain intensity and anxiousness correlate with patient acceptance?

Harnik, Michael Alexander; Blättler, Larissa Tatjana; Limacher, Andreas; Reisig, F.; Holtforth, Martin Grosse; Streitberger, Konrad

doi:10.1111/papr.13071

Cited by 18 publications

(25 citation statements)

References 19 publications

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“… 24 These findings highlight the importance of ensuring that individuals with chronic conditions continue to have stable access to various therapies even amidst public health crises. 64 Utilization of virtual telemedicine can help to improve access for some individuals, 65 , 66 but such online interventions must include evidence-based, multidisciplinary pain management supports 64 and, as highlighted in our analysis, virtual care may not always be a suitable alternative.…”

Section: Discussionmentioning

confidence: 97%

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

Killackey

Soltani

Noel

et al. 2023

Canadian Journal of Pain

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Introduction Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings. Methods Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach. Results Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management). Discussion/Conclusions Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future.

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Section: Discussionmentioning

confidence: 97%

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

Killackey

Soltani

Noel

et al. 2023

Canadian Journal of Pain

View full text Add to dashboard Cite

show abstract

“… 58 Another study by Harnik et al found patients’ acceptance of telemedicine during the COVID-19 pandemic was high overall but lower among those with levels of pain and anxiety higher than the mean indicating telemedicine may not suffice for this subgroup. 59 Another recent narrative review detailed best practices for telehealth use and remote physical examinations. 60 Other studies of single provider delivery of telemedicine interventions for chronic pain have found that patients generally find delivery of these interventions via telemedicine acceptable.…”

Section: Discussionmentioning

confidence: 99%

Implementation and Preliminary Effectiveness of a Multidisciplinary Telemedicine Pilot Initiative for Patients with Chronic Non-Cancer Pain in Rural and Underserved Areas at a Major Academic Medical Center

Hayes

Gannon

Woodward

et al. 2023

JPR

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Background: Arkansas lacks adequate access to high-quality pain care, as evidenced, in part, by it having the second highest opioid prescribing rate in the United States. To improve access to high-quality treatment of chronic pain, we developed the Arkansas Improving Multidisciplinary Pain Care and Treatment (AR-IMPACT) Telemedicine Clinic, a multidisciplinary and interprofessional team of specialists who provide evidence-based pain management for patients with chronic pain. Methods: We conducted a single-arm pilot trial of the AR-IMPACT Telemedicine Clinic with rural, university-affiliated primary care clinics. We assessed the AR-IMPACT Telemedicine Clinic using an implementation framework and preliminary effectiveness measures. Specifically, we assessed 5 of the 8 implementation outcomes of the framework (ie, penetration, adoption, acceptability, appropriateness, and feasibility) using a mixed methods approach. To evaluate implementation outcomes, we used surveys, interviews, and administrative data. We used electronic health record data to measure preliminary effectiveness (ie, changes in average morphine milligram equivalents per day and pain and depression scores). Results:The AR-IMPACT team saw 23 patients that were referred by 13 primary care physicians from three rural, universityaffiliated primary care clinics over one year. Of the 19 patients willing to participate in the pilot study, 12 identified as women, 31.6% identified as Black, and over 50% had less than a bachelor's level education. Patients rated the clinic positively with high overall satisfaction. Referring physicians indicated high levels of appropriateness, acceptability, and feasibility of the program. AR-IMPACT team members identified several barriers and facilitators to the feasibility of implementing the program. No changes in preliminary effectiveness measures were statistically significant. Conclusion: Overall, the AR-IMPACT Telemedicine Clinic obtained moderate penetration and adoption, was highly acceptable to patients, was highly acceptable and appropriate to providers, and was moderately feasible to providers and AR-IMPACT team members.

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“…In many cases, pain catastrophising or anxiety was linked to greater perceived severity of pain during the pandemic [78,81]. Although widespread adoption of telemedicine facilitated healthcare access, patients with higher pain burden or level of anxiety were found to be less accepting of telemedicine [82] and patients who also had delays or cancellations of interventions were more likely to report increased pain [83,84]. There was a substantial increase in opioid overdose deaths in the United States and Canada during the pandemic [5,85], but it is not clear if opioid prescriptions to pain patients was contributory.…”

Section: Pandemic Influence On Patients With Pre-existing Chronic Painmentioning

confidence: 99%

The COVID‐19 pandemic and its consequences for chronic pain: a narrative review

et al. 2022

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Summary The COVID‐19 pandemic transformed everyday life, but the implications were most impactful for vulnerable populations, including patients with chronic pain. Moreover, persistent pain is increasingly recognised as a key manifestation of long COVID. This narrative review explores the consequences of the COVID‐19 pandemic for chronic pain. Publications were identified related to the COVID‐19 pandemic influence on the burden of chronic pain, development of new‐onset pain because of long COVID with proposed mechanisms and COVID‐19 vaccines and pain interventions. Broadly, mechanisms underlying pain due to SARS‐CoV‐2 infection could be caused by ‘systemic inflammatory‐immune mechanisms’, ‘direct neuropathic mechanisms’ or ‘secondary mechanisms due to the viral infection or treatment’. Existing chronic pain populations were variably impacted and social determinants of health appeared to influence the degree of effect. SARS‐CoV‐2 infection increased the absolute numbers of patients with pain and headache. In the acute phase, headache as a presenting symptom predicted a milder course. New‐onset chronic pain was reportedly common and likely involves multiple mechanisms; however, its prevalence decreases over time and symptoms appear to fluctuate. Patients requiring intensive support were particularly susceptible to long COVID symptoms. Some evidence suggests steroid exposure (often used for pain interventions) may affect vaccine efficacy, but there is no evidence of clinical repercussions to date. Although existing chronic pain management could help with symptomatic relief, there is a need to advance research focusing on mechanism‐based treatments within the domain of multidisciplinary care.

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Telemedicine for chronic pain treatment during the COVID‐19 pandemic: Do pain intensity and anxiousness correlate with patient acceptance?

Cited by 18 publications

References 19 publications

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

Implementation and Preliminary Effectiveness of a Multidisciplinary Telemedicine Pilot Initiative for Patients with Chronic Non-Cancer Pain in Rural and Underserved Areas at a Major Academic Medical Center

The COVID‐19 pandemic and its consequences for chronic pain: a narrative review

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