mHealth: a strategic field without a solid scientific soul. a systematic review
Mobile health (mHealth) has undergone exponential growth in recent years. Patients and healthcare professionals are increasingly using health-related applications, at the same time as concerns about ethical issues, bias, conflicts of interest and privacy are emerging. The general aim of this paper is to provide an overview of the current state of development of mHealth.
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http://www.ncbi.nlm.nih.gov/pubmed/25027137
http://jama.jamanetwork.com/article.aspx?articleid=1887741
Advancing Telecare for Pain Treatment in Primary Care
JAMA. 2014;312(3):235-236. doi:10.1001/jama.2014.7690.
Chronic musculoskeletal pain accounts for an estimated 60 million ambulatory care visits in the United States each year and significantly impairs quality of life.1,2 Management of chronic musculoskeletal pain is frequently frustrating, both for patients and for their primary care physicians. Underrecognition and undertreatment of chronic pain have led to routine measurement and documentation of pain as “the fifth vital sign” as well as efforts to increase awareness of pain symptoms among clinicians.3 However, in the absence of effective systems for implementing evidence-based approaches for treating chronic pain, improved awareness of pain has resulted in increased and sometimes indiscriminate prescribing of chronic opioids, with harmful effects.4 Because of the high prevalence of chronic pain and the limited capacity of specialty pain clinics, effective interventions are needed that can be safely and widely implemented by primary care practices.
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http://www.ncbi.nlm.nih.gov/pubmed
(telemedicine) AND pain
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106145/
http://www.ncbi.nlm.nih.gov/pubmed/24846620
http://linkinghub.elsevier.com/retrieve/pii/S1551-7144(14)00073-1
Contemp Clin Trials. 2014 Jul;38(2):213-20. d
Development and implementation of a telehealth-enhanced intervention for pain and symptom management.
Abstract
Managing chronic pain effectively is often challenging for health care providers and patients. Telehealth technologies can bridge geographic distance and improve patients' quality of care in communities where access to pain specialists has previously been unavailable. This paper describes the development and evaluation of a telehealth intervention (TelePain) designed to address the need for pain specialist consultation regarding pain and symptom management issues in non-academic medical centers. We describe the theoretical foundation and development of a multifaceted intervention using a cluster randomized clinical trial design. Health care providers and their patients with chronic pain are enrolled in the study. Patient participants receive the intervention (report of symptoms and receipt of a pain graph) weekly for 8 weeks and are contacted at 12 weeks for completion of post-intervention follow-up measures. Their providers attend TelePain sessions which involve a didactic presentation on an evidence-based topic related to pain management followed by patient case presentations and discussion by community clinicians. Symptom management recommendations for each patient case are made by a panel of pain specialists representing internal medicine, addiction medicine, rehabilitation medicine, anesthesiology, psychiatry, and nursing. The outcomes assessed in this randomized trial focus on pain intensity, pain's interference on function and sleep, and anxiety, depression, and cost-effectiveness. Some of the challenges and lessons that we have learned early in implementing the TelePain intervention are also reported.
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