Introduction

Chronic pain constitutes a significant burden for the individuals affected and is a frequent reason why patients seek health care services. While in-person interventions can be of support to people living with chronic pain, such interventions are not always accessible, such as during the recent Covid-19 pandemic. Telemedicine interventions may provide greater accessibility, especially for elderly and fragile patients, but the evidence and use of digital solutions for chronic pain are still limited. The aim of this study is to investigate attitudes towards, and use of telemedicine for patients with chronic pain.

Methods

Between May 2020 and May 2023 data were collected from the Pain Therapy Unit of Azienda Ospedaliera Universitaria Pisana, equipped with the necessary digital interfaces to organize a telemedicine service. During the first in-person visit, the access method for telemedicine is explained, and an informed consent form is provided. After the first in-person visit, a follow-up visit reminder, including the necessary instructions to access the teleservice is offered as option to the patient. During the follow-up visit the provider can control clinic condition, assess pain, do prescriptions as well as controlling the neuromodulation devices remotely. Data collected included: number of patients, age, and the number of follow-ups requested by the patient.

Results

From May 2020 to May 2023, a total of 1465 follow-up telemedicine visits for chronic pain were conducted. The average over the 3-year period was 40.7 televisits per month. In 2020 (7 months; May-Dec), the average was 47.7 televisits per month. In 2021 and 2022, there was a decrease in telemedicine visits, with an average of 38 per month and 29 per month, respectively. In the first 5 months of 2023, the average was 65.5 telehealth visits per month. Average age decreased throughout the study period: 63.6 yo; 59.3 yo and 57.8 yo for years 2021 to 2023, respectively. Moreover, between yy 2021 and 2023 51.7% of patients had 2 or more telemedicine follow-up visit.

Conclusions

Our experience highlights the positive feedback from patients regarding telemedicine follow-up visits for chronic pain management as showed by the percentage of patients who rescheduled 2 or more telemedicine follow-up visit throughout the study period. Moreover, these findings suggest that the convenience and accessibility of telemedicine have been well-received. The adoption of telemedicine has allowed us to overcome barriers to care and establish a continuous and supportive patient-provider relationship. The patient preference for telemedicine follow-up visits suggests its potential as a valuable tool in the management of chronic pain. Although further implementation of telemedicine services in this field is needed, increased accessibility particularly by elderly and fragile patients who might have been previously marginalized or isolated, as well the ability to remotely control the neuromodulation devices, may greatly contribute to an optimal management of chronic pain resulting in improved patients’ quality of life.

References

1.Telemedicina. Linee di indirizzo nazionali: https://www.salute.gov.it

2.Y. Hadjiat e al. Digital health in pain assessment, diagnosis, and management: Overview and perspectives. Front. Pain Res. 4:1097379.

3.K. Choe et al. Impact of COVID-19 pandemic on chronic pain and opioid use in marginalized populations: A scoping review. Front. Public Health 11:1046683.