| One-Minute Clinician

Older Patients, Mobile Devices and Pain Management

Smartphone technology has been rapidly emerging and now there are about 44,000 health-related applications out on the market. A substantial proportion are directed at improving outcomes in people who suffer from pain. For older patients who live alone, they can be important clinical eyes and ears; a way for physicians to monitor patients and to understand whether treatments are having their anticipated benefits or perhaps leading to unanticipated and unwanted side effects. They can also deliver education about the use of specific techniques such as exercises, yoga as relaxation. So the devices can really be thought of as ways to deliver interventions, to monitor for treatment outcomes, to establish the baseline against which we would understand whether our treatments are improving outcomes or perhaps making them go in the other direction. I think the prompts that people can relieve can also reinforce treatment adherence. There are really a ton of theoretical advantages to the use of the tools.

Often what we hear is that older adults are not going to adapt to the use of these tools, but what our research suggests is quite the opposite: that they’re very receptive to them. The devices and apps need to be functionally appropriate for our older patients in particular. But our work suggests that older adults are willing to try them. Patients worry less in our studies about privacy issues, and most of the older adults that we’ve interviewed suggest that in fact they like that oversight and reassurance that it provides. From the provider perspective there are concerns like “Well, am I going to get reimbursed for processing information that comes to me out of the context of a clinical visit?” Right now we’ve got to see patients face-to-face in order to get the billing for that. They also worry about liability issues. And physicians are concerned about too much information coming in because these devices literally can collect lots and lots of data. But I have every reason to believe that the devices will play an important role in helping us to understand whether our treatments are having the intended effect and help us to identify people who are trending towards a negative health event. I think another dividend from the use of these devices that’s been less talked about is the ability to form social networks and certainly we know that pain isolates people so that the extent to which people use these tools to establish and enhance socialization I think would be a very positive result

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