A Painless Effort with Digitalization in Pain Management
Friday, February 10, 2023
Pain causes widespread and profound disability and suffering. Seventy percent of emergency room patients report acute pain, while up to fifty percent of the US population experiences chronic pain.
FREMONT, CA: Pain is the unpleasant sensory and emotional experience resulting from real or anticipated tissue injury. It is classified as nociceptive pain, which develops due to receptor activation by a specific stimulus like a broken bone or burnt tissue, and neuropathic pain, which arises from disease or malfunctioning of the nervous system without a specific external stimulus. Although nociceptive pain is more frequently associated with brief duration and fades when the wounded tissue heals, both forms of pain can be acute (3 months) or chronic (3 months).
Since 50 million people in the United States have chronic pain, it is unsurprising that chronic pain is one of the most prevalent reasons patients seek medical care. The incidence of chronic pain-causing illnesses, such as osteoarthritis and sarcopenia, will increase due to an aging population and changes in lifestyle, which are predicted to increase the prevalence of chronic pain. Chronic pain is typically managed in an outpatient environment, and over 70 percent of patients admitted to the emergency department report experiencing acute pain. In all instances, pain is connected with substantial physical, emotional, and social difficulties, totaling hundreds of billions of dollars in direct medical bills, lost productivity, and disability insurance. In a widely cited publication, the US Journal of Pain estimated that the annual cost of chronic pain management ranged from $560 billion to $636 billion.
Non-Pharmacological Approach to Pain Management
From the 1970s to the 1990s, a growing understanding of the underlying mechanisms that generate pain and the advent of novel pain drugs led many to assume that the medical community and pharmaceutical firms could significantly reduce the prevalence of uncontrolled pain. Unfortunately, the efficacy of these interventions fell short of expectations, and the overuse of opioid-based treatments contributed to the opioid crisis. Multiple institutions, such as the National Academy of Medicines or the National Institutes of Health's Strategy for Pain, are therefore promoting a shift from pharmacology-based approaches to a more patient-centric, collaborative care-based approach that emphasizes the patient's essential role in the management of their pain-related condition. Many non-pharmacological pain management strategies have a well-documented history of success, and these can be roughly categorized as behavioral, movement-based, and mind-body therapies.
However, the widespread adoption of these alternative, non-pharmacological treatment methods has been limited due to a lack of payer coverage, limited provider availability, and physician ignorance and resistance.
The Emergence of Digital Pain Management Solutions
Given the prevalence of linked devices and the increasing digitalization of healthcare services and systems, digital solutions can be utilized to overcome the inadequacies of these established non-pharmacological therapy techniques for pain management. Many methods have reached the commercial stage recently and are now available to patients.
These solutions digitize the non-pharmacological techniques for pain management depicted in the preceding picture (mind-body, movement-based, and behavioral approaches). They improve access to these interventions by utilizing telemedicine or eliminating the human provider. For instance, Kaia's solution, for example, is software-only and employs mobile phones and visualization technology to coach patients through their workouts. On the other hand, Omada's approach is based on a telemedicine platform that eliminates the geographical barrier between in-person therapists and patients and is complemented by visualization technologies that measure patients' motion range progress. A central tenet of the National Institutes of Health (NIH) national pain strategy, both approaches lay greater treatment responsibility on the patient.
Developers of these technologies are appropriately focused on establishing convincing proof of clinical efficacy and guaranteeing robust market access via payer reimbursement. Kaia, for instance, prepared its Rise-uP clinical trial as a randomized, two-arm research comprising 1,248 patients. After it proved efficacy, the innovation office of the Federal Joint Committee (G-BA) requested that Rise-uP be included in the reimbursable service portfolio.
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