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一种创新的电子健康工具包(全人关怀慢性疼痛课程),用于减少健康差异患者的慢性疼痛:开放临床试验。

An Innovative Electronic Health Toolkit (Our Whole Lives for Chronic Pain) to Reduce Chronic Pain in Patients With Health Disparities: Open Clinical Trial.

机构信息

Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States.

Department of Family Medicine, Boston Medical Center, Boston, MA, United States.

出版信息

JMIR Mhealth Uhealth. 2020 Mar 30;8(3):e14768. doi: 10.2196/14768.

Abstract

BACKGROUND

Chronic pain affects millions of Americans. Our Whole Lives, an electronic health (eHealth) toolkit for Chronic Pain (Our Whole Lives for Chronic Pain [OWLCP]), is a mind-body chronic pain management platform that teaches self-management strategies to reduce pain impact and pain medication use.

OBJECTIVE

The primary goal of this study was to evaluate the feasibility of OWLCP in reducing pain impact and pain-related outcomes.

METHODS

We conducted a pre-post clinical study (2 cohorts) to assess the feasibility of OWLCP usage among low-income patients with chronic pain. Outcome data, collected at baseline and 9 weeks, included Patient-Reported Outcomes Measurement Information System (PROMIS-29), pain self-efficacy, and pain medication use. In the statistical analysis, we used descriptive statistics, logistic regression, linear regression, and qualitative methods.

RESULTS

Among the enrolled 43 participants, the average age was 50 years, (39/43) 91% were female, (16/43) 37% were black, and (7/43) 16% were Hispanic. From baseline to follow-up, the PROMIS measures showed a reduction in depression (P=.02), pain interference (P=.003), and average pain impact score (P=.007). Pain self-efficacy increased ((P<.001), whereas opioid use had a 13% reduction (P=.03).

CONCLUSIONS

The eHealth chronic pain management platform, OWLCP, is a potential tool to reduce the impact of chronic pain for low-income racially diverse populations.

摘要

背景

慢性疼痛影响着数以百万计的美国人。我们的全生活(Whole Lives),一个用于慢性疼痛的电子健康(eHealth)工具包(我们的全生活用于慢性疼痛[OWLCP]),是一个身心慢性疼痛管理平台,教授自我管理策略,以减轻疼痛的影响和减少止痛药的使用。

目的

本研究的主要目的是评估 OWLCP 在减轻疼痛影响和疼痛相关结果方面的可行性。

方法

我们进行了一项前后对照的临床研究(2 个队列),以评估 OWLCP 在患有慢性疼痛的低收入患者中使用的可行性。在基线和 9 周时收集的结果数据包括患者报告的测量信息系统(PROMIS-29)、疼痛自我效能和疼痛药物使用情况。在统计分析中,我们使用了描述性统计、逻辑回归、线性回归和定性方法。

结果

在纳入的 43 名参与者中,平均年龄为 50 岁(39/43),91%为女性(16/43),37%为黑人(16/43),16%为西班牙裔(7/43)。从基线到随访,PROMIS 测量显示抑郁(P=.02)、疼痛干扰(P=.003)和平均疼痛影响评分(P=.007)降低。疼痛自我效能感增加(P<.001),而阿片类药物的使用减少了 13%(P=.03)。

结论

电子健康慢性疼痛管理平台 OWLCP 是一种有潜力的工具,可以减轻低收入、种族多样化人群慢性疼痛的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6599/7154936/7dc77abb161a/mhealth_v8i3e14768_fig1.jpg

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