An evaluation of a digital pain management programme: clinical effectiveness and cost savings.

INTRODUCTION: Chronic pain is one of the most prevalent causes of disability worldwide, and digital interventions may be one of the ways to meet this need. Randomised controlled trials have demonstrated that digital interventions can be effective in treating chronic pain. This study aimed to establish the clinical effectiveness of a web-based pain management programme (PMP), specifically whether it would lead to improved clinical outcomes and reduced health care costs in a real-world clinical setting. METHODS: Of 738 participants, 438 engaged with the programme and 300 did not. Two analyses were conducted: a within-subjects pre-post comparison of clinical outcomes for participants who completed the programme and a between-groups comparison of health care usage for those who engaged and those who did not. RESULTS: Participants who completed the programme made significant improvements with regard to their perceived health status, level of disability, mood, confidence managing pain, problems in life due to pain and level of pain. Around one-third of participants made reliable changes in their levels of disability, depression and anxiety. There was no relationship between gender or age and engagement with the programme. Those who engaged with the programme demonstrated reduced health care costs in the year following referral, whereas health care costs of non-engagers increased. Limitations of the study include a high drop-out rate and a non-randomised comparison group. Results must therefore be interpreted with some caution. CONCLUSION: A web-based pain management programme can be clinically effective and may be a useful addition to the treatments offered by pain management services.

Get yourself connected.

New technology is increasingly being used to help meet growing demands for health care. But it is not without its problems.

Use of digital images in the assessment and treatment of pressure ulcers in patients with spinal injuries in community settings.

We conducted a retrospective review of the digital images in the clinical records of 50 patients with pressure ulcers. Ten nurses independently assessed one image from each patient. There was a total of 414 responses from the nurses about the stage and location of the ulcers (83% response rate). The average agreement about the stage and location of the ulcers was 85%. The overall agreement declined as the stage of the ulcer increased. The average agreement regarding the wound descriptors was: necrosis 85%, granulation tissue 81%, ischaemia 83%, cellulitis /infection 69%, erythema 68%. Almost all nurses felt the need to change the current management of the wound (460 responses, or 92%). The nurses judged that most digital images were of good quality (17%) or very good quality (79%). The present study suggests that a high percentage of assessments for patients currently travelling to specialist clinics could be performed in the community using digital images and telemedicine.

Telemedicine in healthcare. 2: The legal and ethical aspects of using new technology.

This article explores the legal and ethical issues that nurses need to consider when planning, designing and implementing telemedicine. It considers key issues such as patient confidentiality, privacy, data security and transmission, and outlines key points for practice.

Telemedicine in healthcare. 1: Exploring its uses, benefits and disadvantages.

This first in a two part series on telemedicine in healthcare outlines the background and context for using this technology. It discusses the levels of telemedicine and its possible applications in healthcare, and examines its advantages and disadvantages.