Managing chronic pain and pain medication
Chronic pain affects one in five Australians. Pain is considered chronic when it's experienced most days of the week for more than three months.
The causes of chronic pain are wide-ranging, from migraines and arthritis to injuries and surgeries, though sometimes the cause is not known. While it varies in cause and intensity, chronic pain in any form can reduce a sufferer's quality of life, affecting mood and emotional wellbeing and sometimes leading to depression or anxiety.
Some painkillers can provide respite from chronic pain, but their long-term use can sometimes lead to misuse, posing serious risks like dependence, addiction and even accidental fatal overdose.
We’ve co-developed a mobile platform for pain intervention
Working with Metro North Hospital and Health Service and the University of Queensland, our researchers at the Australian eHealth Research Centre developed Pain ROADMAP, a mobile platform comprising a smartphone app for patients and a portal for clinicians.
Underpinning the mobile app is an evidence-based treatment strategy for managing pain called activity pacing. Based on the knowledge that physically doing too much, or too little, can aggravate pain, activity pacing involves identifying which activities trigger a person's pain, and then strategically scheduling or staggering these activities throughout the day. This can help to reduce the frequency and intensity of the pain these activities cause.
Historically, people have struggled with activity pacing, simply because it was difficult to pinpoint which activities caused them the most pain.
With the Pain ROADMAP app, users can track their daily activities, log their pain levels as they complete these activities, and note what pain medication they take and when. An actigraph accelerometer worn around their waist can keep track of when they are moving and resting.
This data is sent to a portal for the users' clinicians, where an entire snapshot of the patient's pain experience on any given day or week is recorded, including when their pain is at its worst, how much of their time is spent sedentary, and how they use pain medication.
With this detailed information, clinicians can help their patients with activity pacing, knowing exactly which activities and behaviours which, if changed or broken up throughout the day, might help to reduce the frequency or intensity of the pain they experience.
Helping to stabilise pain
We recently trialled our Pain ROADMAP app in a three-month feasibility study with 20 people living with chronic pain.
Our research participants used the smartphone app to track their daily activities, pain levels, and medication intake, and their clinicians examined this information through the portal.
The study found that interventions using the app helped people reschedule activities. Participants found that they had fewer periods of over-activity, the app helped stabilise their pain, and they got an average 49 minutes more productivity out of their days.
Importantly, for five of seven people in the study that relied on take-as-needed pain medication, they were able to stop taking it, and opioid medication decreased by 20 per cent on average.
With continued updates to and trials of the Pain ROADMAP platform, we’re determining the feasibility of its widespread use in pain clinics across Australia.
In 2019, the Pain ROADMAP platform was merit recipient for two awards at the at the National iAwards.