Telemedicine for Chronic Pain in the COVID-19 Era and Beyond

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Ever since the COVID-19 pandemic, society, in general, has been through a lot of changes. Social interactions, for instance, have been reduced to mitigate the spread of the virus. For this reason, the importance of remote interactions between healthcare providers and patients has been brought to the forefront. 

Expanding a telemedicine practice is becoming increasingly crucial for doctors, as it provides them with the enormous opportunity to reach patients almost anywhere with an internet connection. To ensure uninterrupted telemedicine sessions, it's important to have a secure and fast internet connection, especially when consulting a physician for certain conditions like chronic pain. While alternative treatments may be helpful, it's always recommended to consult with a physician to ensure the best course of action.

What Is Telemedicine?

Telemedicine refers to video or audio interactions between patients and their healthcare providers. It includes remote consultation, monitoring, counseling, and diagnosis. 

Benefits of Telemedicine for Chronic Pain

Chronic pain may last over three months. The pain may be felt in different body parts and may come and go depending on the severity of the condition. 

Chronic pain may interfere with your everyday routines, leading to depression, anxiety, and sleep difficulties. Hence, you must stay connected with your healthcare provider regularly. 

This section will discuss the benefits of telemedicine for chronic pain. 

Top 4 Benefits of Telemedicine for Chronic Pain Treatment 

1. Bridging Medical Care Gaps 

Healthcare providers can complete telemedicine evaluations in a skilled nursing facility before discharge to coordinate transition care. In addition, this medical approach can be used to correlate outpatient pain management before discharge from an outside emergency room or hospital. 

2. Efficiency and Convenience   

A 2021 qualitative survey study examined physicians’ perspectives on telemedicine during the COVID-19 pandemic in China. The clinicians’ attitudes toward telemedicine were positive, with 88.4% of the respondents stating their willingness to adopt this medical approach. The result showed that the primary reason for healthcare providers’ willingness to adopt telemedicine included convenience for patients. Other reasons include:

  • Increased diagnosis and treatment efficiency
  • Reduced patient burden
  • Conduciveness to medical equity
  • Reduced medical costs 
  • Enhanced patient satisfaction 

An observational study from JMIR Human Factors showed high patient satisfaction with telemedicine amidst the COVID-19 crisis. Based on the study, patient satisfaction with telemedicine stems from the degree of trust in their physicians. 

Meanwhile, a cost analysis study examined telemedicine in the management of chronic pain. Results showed that telemedicine is cost-effective over many assumptions, including fuel costs, travel distance, annual patient volumes, discount rates, and amortization. 

3. Psychosocial and Motivational Considerations

Physicians may obtain an informal evaluation of a patient’s mental health status through audio or video telemedicine. They may also observe other social information like how you interact with your family, relatives, or other people in your household. 

By having all the information gathered from audio or video telemedicine, your clinician may better understand your commitment to and compliance with previous and future recommendations.   

4. Remote Comprehensive Evaluation 

A doctor can still perform a comprehensive history and examination if a video telemedicine evaluation includes a review of the diagnosis received through a separate web-based application. Examples of these web-based applications include pain, sleep, mood, and expectation ratings.

Disadvantages of Telemedicine in Chronic Pain 

Like any other medical approach, telemedicine also has drawbacks, including: 

1. Reduced Quality of Provider-Patient Interaction 

Without a physical interaction between you and your healthcare provider, nonverbal cues are lost, making it difficult to discuss complex issues related to pain management. There’s also a possibility of bias because your physician only sees your home environment and social cues via telemedicine. 

2. Inadequate Patient Engagement

Additional distractors at home, such as other people in the household, television, computer, and other gadgets, may affect your engagement during your telemedicine session. In addition, video connections can be unreliable at times. When lag time exists, it can limit a smooth conversation between you and your healthcare provider. 

3. Cost Considerations 

There are persistent questions about national and local reimbursement for telemedicine, not to mention the lack of hospital facility fees and co-pays for telemedicine visits. During the COVID-19 emergency, you may be billed by time for every telemedicine phone appointment.

4. Limitations in Physical Examination 

As for the safety and feasibility of a virtual physical exam, most specialties have demonstrated ways of adapting through advanced technology or the assistance of another healthcare worker, with very few cases of adverse events. However, a proper physical examination is necessary for common pain complaints to establish a differential diagnosis. Moreover, a physical exam may help differentiate disease progression from variation because of natural history. 

If an in-person visit is not possible or extremely challenging, some procedures may not be performed accordingly. In addition, not all procedures can be covered by insurance. Hygiene and behavior may also be difficult to examine without a face-to-face visit.  

Conclusion

Telemedicine is a promising medical approach. Patients with an established relationship with their physicians may be the most suitable for it. Still, telemedicine isn’t a one-size-fits-all alternative to traditional medical consultations and procedures. Therefore, it’s necessary to analyze its effect on healthcare systems as clinical care provisions evolve after the COVID-19 global health crisis. 

References

  1. Telehealth and Telemedicine during COVID-19 in Low Resource Non-U.S. Settings
  2. Benefits of Telemedicine in Pain Management
  3. Primary healthcare providers challenged during the COVID-19 pandemic: a qualitative study
  4. Physicians’ Perspectives of Telemedicine During the COVID-19 Pandemic in China: Qualitative Survey Study
  5. Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: Retrospective Cohort Study

Stanley Clark is a community development volunteer and writer. He worked on several commercials, events, and campaigns before becoming a full-time writer in the area of natural health and wellness.

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Dr. Wilson graduated from Rosalind Franklin University of Medicine and Science and completed her residency in Internal Medicine at Advocate Good Shepherd Hospital in Barrington, IL. Dr. Wilson specializes in providing culturally competent and trauma-informed care to patients with physical disabilities. In addition to her private practice, she works as a science communicator, teaching health literacy to middle school and high school students in her local school district. 

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