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辅助数字干预改善基于阿片类药物的疼痛管理:虚拟现实和移动应用对以患者为中心的药学护理的影响。

Adjunct Digital Interventions Improve Opioid-Based Pain Management: Impact of Virtual Reality and Mobile Applications on Patient-Centered Pharmacy Care.

作者信息

Giravi Hayam Y, Biskupiak Zack, Tyler Linda S, Bulaj Grzegorz

机构信息

University of Utah College of Pharmacy, Salt Lake City, UT, United States.

Department of Medicinal Chemistry, L.S. Skaggs College of Pharmacy, University of Utah, Salt Lake City, UT, United States.

出版信息

Front Digit Health. 2022 Jun 13;4:884047. doi: 10.3389/fdgth.2022.884047. eCollection 2022.

Abstract

Digital therapeutics (DTx, mobile medical apps, software as a medical device) are rapidly emerging as clinically effective treatments for diverse chronic diseases. For example, the Food and Drug Administration (FDA) has recently authorized a prescription virtual reality (VR) app for treatment of moderate to severe low back pain. The FDA has also approved an adjunct digital therapy in conjunction with buprenorphine for opioid use disorder, further illustrating opportunities to integrate digital therapeutics with pharmacotherapies. There are ongoing needs to disseminate knowledge about advances in digital interventions among health care professionals, policymakers, and the public at large. This mini-review summarizes accumulating clinical evidence of digital interventions delivered virtual reality and mobile apps to improve opioid-based analgesia. We identified relevant randomized controlled trials (RCTs) using Embase and PubMed databases which reported pain scores with a validated pain scale (e.g., visual analog scales, graphic rating scale, numeric rating scale) and use of a digital intervention in conjunction with opiates. Among identified RCTs, the majority of studies reported improved pain scores in the digital intervention group, as compared to "treatment as usual" group. Our work suggests that VR and mobile apps can be used as adjunct digital therapies for pain management. We discuss these findings in the context of how digital health technologies can transform patient-centered pharmacy care.

摘要

数字疗法(DTx,移动医疗应用程序,软件即医疗器械)正迅速成为治疗多种慢性病的临床有效方法。例如,美国食品药品监督管理局(FDA)最近批准了一款用于治疗中度至重度腰痛的处方虚拟现实(VR)应用程序。FDA还批准了一种与丁丙诺啡联合使用的辅助数字疗法用于阿片类药物使用障碍,这进一步说明了将数字疗法与药物疗法相结合的机会。目前,医疗保健专业人员、政策制定者和广大公众都迫切需要了解数字干预措施的进展情况。这篇小型综述总结了通过虚拟现实和移动应用程序进行数字干预以改善阿片类镇痛效果的临床证据。我们使用Embase和PubMed数据库确定了相关的随机对照试验(RCT),这些试验报告了使用经过验证的疼痛量表(如视觉模拟量表、图形评定量表、数字评定量表)得出的疼痛评分以及数字干预措施与阿片类药物联合使用的情况。在已确定的随机对照试验中,与“常规治疗”组相比,大多数研究报告数字干预组的疼痛评分有所改善。我们的研究表明,虚拟现实和移动应用程序可作为疼痛管理的辅助数字疗法。我们将在数字健康技术如何改变以患者为中心的药学服务的背景下讨论这些发现。

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