Sang Ling, Zheng Bixin, Zeng Xianzheng, Liu Huizhen, Jiang Qing, Liu Maotong, Zhu Chenyu, Wang Maoying, Yi Zengwei, Song Keyu, Song Li
Department of Pain Management, West China Hospital, Sichuan University, No 37 Guoxue Xiang, Wuhou District, Chengdu, 610041, China, 86 18980601501.
Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China.
JMIR Med Inform. 2024 Dec 30;12:e54975. doi: 10.2196/54975.
Chronic pain is widespread and carries a heavy disease burden, and there is a lack of effective outpatient pain management. As an emerging internet medical platform in China, internet hospitals have been successfully applied for the management of chronic diseases. There are also a certain number of patients with chronic pain that use internet hospitals for pain management. However, no studies have investigated the effectiveness of pain management via internet hospitals.
The aim of this retrospective cohort study was to explore the effectiveness of chronic pain management by internet hospitals and their advantages and disadvantages compared to traditional physical hospital visits.
This was a retrospective cohort study. Demographic information such as the patient's sex, age, and number of visits was obtained from the IT center. During the first and last patient visits, information on outcome variables such as the Brief Pain Inventory (BPI), medical satisfaction, medical costs, and adverse drug events was obtained through a telephone follow-up. All patients with chronic pain who had 3 or more visits (internet or offline) between September 2021, and February 2023, were included. The patients were divided into an internet hospital group and a physical hospital group, according to whether they had web-based or in-person consultations, respectively. To control for confounding variables, propensity score matching was used to match the two groups. Matching variables included age, sex, diagnosis, and number of clinic visits.
A total of 122 people in the internet hospital group and 739 people in the physical hospital group met the inclusion criteria. After propensity score matching, 77 patients in each of the two groups were included in the analysis. There was not a significant difference in the quality of life (QOL; QOL assessment was part of the BPI scale) between the internet hospital group and the physical hospital group (P=.80), but the QOL of both groups of patients improved after pain management (internet hospital group: P<.001; physical hospital group: P=.001). There were no significant differences in the pain relief rate (P=.25) or the incidence of adverse events (P=.60) between the two groups. The total cost (P<.001) and treatment-related cost (P<.001) of the physical hospital group were higher than those of the internet hospital group. In addition, the degree of satisfaction in the internet hospital group was greater than that in the physical hospital group (P=.01).
Internet hospitals are an effective way of managing chronic pain. They can improve patients' QOL and satisfaction, reduce treatment costs, and can be used as part of a multimodal strategy for chronic pain self-management.
慢性疼痛普遍存在，疾病负担沉重，且缺乏有效的门诊疼痛管理。作为中国新兴的互联网医疗平台，互联网医院已成功应用于慢性病管理。也有一定数量的慢性疼痛患者使用互联网医院进行疼痛管理。然而，尚无研究调查通过互联网医院进行疼痛管理的有效性。
这项回顾性队列研究的目的是探讨互联网医院对慢性疼痛管理的有效性，以及与传统实体医院就诊相比的优缺点。
这是一项回顾性队列研究。从信息技术中心获取患者的性别、年龄和就诊次数等人口统计学信息。在患者首次和末次就诊期间，通过电话随访获取简明疼痛量表（BPI）、医疗满意度、医疗费用和药物不良事件等结局变量的信息。纳入2021年9月至2023年2月期间有3次或更多次（线上或线下）就诊的所有慢性疼痛患者。根据患者是进行线上咨询还是线下就诊，将患者分为互联网医院组和实体医院组。为控制混杂变量，采用倾向得分匹配法对两组进行匹配。匹配变量包括年龄、性别、诊断和门诊就诊次数。
互联网医院组共有122人，实体医院组共有739人符合纳入标准。经过倾向得分匹配后，两组各有77例患者纳入分析。互联网医院组和实体医院组之间的生活质量（QOL；QOL评估是BPI量表的一部分）无显著差异（P = 0.80），但两组患者在疼痛管理后生活质量均有所改善（互联网医院组：P < 0.001；实体医院组：P = 0.001）。两组之间的疼痛缓解率（P = 0.25）或不良事件发生率（P = 0.60）无显著差异。实体医院组的总费用（P < 0.001）和治疗相关费用（P < 0.001）高于互联网医院组。此外，互联网医院组的满意度高于实体医院组（P = 0.01）。
互联网医院是管理慢性疼痛的有效方式。它们可以改善患者的生活质量和满意度，降低治疗成本，并可作为慢性疼痛自我管理多模式策略的一部分。
