Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Department of Political Sciences, University of Naples "Federico II", Largo S. Marcellino, Naples, Italy.
Pain Med. 2023 Mar 1;24(3):226-233. doi: 10.1093/pm/pnac128.
Telemedicine is defined as the delivery of medical services through a variety of telecommunication tools. This novel approach can fit the needs of cancer patients who cannot often reach clinics due to their disabling symptoms. In this population of patients, pain is undoubtedly the most important symptom which dramatically affects the quality of life. Our work aimed to investigate the effectiveness of telemedicine in the management of cancer pain in order to assess the feasibility of a combination between telemedicine and traditional in-person visits; we also propose a model of integration of these two approaches.
We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to conduct our study. Quality assessment and risk of bias were performed according Cochrane criteria. Results were reported as mean differences and summarized using forest plots. We performed a trial sequential analysis (TSA) to assess the conclusiveness of our results.
Pain severity score and pain interference were lower for patients treated with telemedicine compared to those undergoing classical management (mean difference: -0.408; P =< .001 and -0.492; P = .004, respectively). TSA confirmed that our results were statistically significant and pointed out the need of other studies to reach the required sample size. PROSPERO registration: CRD42022333260.
Telemedicine can be effectively used to manage cancer pain. This novel approach will certainly have a revolutionary economic and organizational impact on health care systems in the next future. Furthermore, the model herein proposed could help set up an algorithm to safely and efficiently implement telemedicine.
远程医疗被定义为通过各种电信工具提供医疗服务。这种新方法可以满足由于残疾症状而经常无法前往诊所的癌症患者的需求。在这些患者中，疼痛无疑是最重要的症状，它极大地影响了生活质量。我们的工作旨在研究远程医疗在癌症疼痛管理中的有效性，以评估远程医疗与传统面对面就诊相结合的可行性；我们还提出了这两种方法相结合的整合模式。
我们遵循系统评价和荟萃分析的首选报告项目（PRISMA）框架进行研究。根据 Cochrane 标准进行质量评估和偏倚风险评估。结果以均值差异表示，并使用森林图进行总结。我们进行了试验序贯分析（TSA）以评估我们结果的结论性。
与接受传统管理的患者相比，接受远程医疗治疗的患者的疼痛严重程度评分和疼痛干扰评分较低（平均差异：-0.408；P < .001 和 -0.492；P = .004）。TSA 证实我们的结果具有统计学意义，并指出需要其他研究来达到所需的样本量。PROSPERO 注册：CRD42022333260。
远程医疗可有效用于治疗癌症疼痛。这种新方法肯定会对未来医疗保健系统的经济和组织产生革命性影响。此外，本文提出的模型可以帮助建立一种安全有效地实施远程医疗的算法。
