Self-Regulation Training for Chronic Pain: Can It Be Done Effectively by Telemedicine?

Abstract

The purpose of this project was to test the efficacy of behavioral telemedicine interventions designed to teach self-regulation skills to chronic pain patients who had not previously been treated. The study sought to determine whether there were differences in outcome and consumer satisfaction with the pain management intervention when delivered by conventional face-to-face methods, by telephone only, and by closed circuit TV (CCTV). We found that self-regulation techniques can be readily taught via behavioral telemedicine interventions. The primary methodologic weakness of the study is that a single experienced clinician provided all of the interventions. Thus, it is not known at this time how well the intervention can be generalized to other clinicians. In addition, there was no control on the administration of the protocols across conditions.

A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation

“…Overall the findings are very encouraging, with patients and therapists reporting positive perceived benefits, convenience and usefulness of the telerehabilitation program. The only study to report any problematic area from the patient's point of view found moderate satisfaction with the interpersonal relationship between patient and therapist [26]. Main complaints from therapists were related to the quality of video transmission [24,27,28], scheduling issues [24], and difficulties in using the technology with certain clienteles such as active or shy children [28].…”

“…Rehabilitation for multiple clienteles (n ¼ 4) [25,26,36,59] Findings limited to one study of behavioural intervention, found no significant difference in relaxation and pain between face-to-face and video conference. Study done in clinical setting with therapist and patient in separate rooms.…”

Telemedicine in the management of chronic pain: a cost analysis study

“…1 Telemedicine has been used successfully in a few specialties, such as psychiatry and cardiology, for counselling and monitoring of treatment response. 2,3 However, TM is relatively new to other medical disciplines. It relies on high-speed, high-bandwidth telecommunication systems that allow two-way real-time clinical consultations over an audio-video link augmented by other modalities, such as an electronic stethoscope and a high-resolution image viewer.…”

A randomized controlled evaluation of an online chronic pain self management program

“…Notable also is the use of self-management methods in an on line format, with a literature that has progressed from case studies and uncontrolled feasibility testing [1,11] to randomized clinical trials [7,29,44]. Although early applications of interventions labeled ‘self-management’ tended to focus on biofeedback methods [40], contemporary approaches attempt to educate persons with pain in a variety of skills and motivational strategies presumed necessary for self-guided symptom management and everyday task persistence.…”