The Centers for Disease Control and Prevention (CDC) and the Medical Board of California (MBC) describe the standard of care for opioid treatment to include patient education (Dowell et al., 2016) (Brown, Jr.,2014). In recent interviews of over 100 physicians, conducted as part of an ongoing National Science Foundation research project, we found that while most prescribers recognized the importance of patient education, few physicians had adequate time. With the introduction of Remote Therapeutic Monitoring (RTM) by CMS in 2022/23 there is recognition of the benefit of adherence monitoring reflected by new provider reimbursement opportunities.
OPOS offers a combined turnkey education and RTM program. The program enables primary care and pain specialty physicians to deliver these services to their chronic pain patients receiving long term opioid therapy as part of their pain management treatment plan. OPOS provides all of the resources, including board certified pain specialists to deliver the patient education so there are no demands on existing provider or practice resources. The combination of education and RTM makes opioids a safer and more effective therapy for chronic pain patients by addressing several aspects of opioid use, including enhancing patient understanding, improving adherence, promoting self-management, and facilitating early intervention. Here's how these two approaches work in a symbiotic manner:
1. Enhancing patient understanding: Combining education with RTM can empower patients with a better understanding of the risks and benefits of opioids, safe usage, storage, and disposal, and recognizing and managing side effects. This knowledge can promote safer and more effective opioid use (Dowell et al., 2016).
2. Improving adherence: Education can improve patients' adherence to opioid therapy by emphasizing the importance of following prescribed regimens. Remote Therapeutic Monitoring can monitor adherence and provide feedback to patients and healthcare providers, enabling timely interventions if discrepancies are detected (Häuser et al., 2014).
3. Promoting self-management: Education can help patients develop self-management skills, such as goal-setting, problem-solving, and relaxation techniques, while RTM can provide ongoing support and personalized feedback on their progress (De la Vega & Miró, 2016).
4. Facilitating early intervention: Remote Therapeutic Monitoring can help healthcare providers detect potential opioid misuse or adverse effects early, enabling them to intervene promptly and adjust treatment plans as needed. Education can help patients recognize warning signs and encourage them to communicate concerns with their healthcare providers (Jamison et al., 2013).
5. Integration with non-pharmacological treatments: Combining education and RTM can support the integration of non-pharmacological treatments for chronic pain, such as cognitive-behavioral therapy, which can improve pain management and potentially reduce the reliance on opioids (Eccleston et al., 2020).
In summary, the combination of education and remote therapeutic monitoring can contribute to making opioids a safer and more effective therapy for patients with chronic pain by enhancing patient understanding, improving adherence, promoting self-management, and facilitating early intervention. OPOS delivers programs to not only meet these goals but to also create new revenue streams for practices. Let us share more details of the successes we have seen in patients and providers that utilize these services.
References
Brown, Jr., E., Sewell, S, Kirchmeyer, K Brown Jr · 2014. Guidelines for Prescribing Controlled Substances for Pain. Medical Board of California, 2014.
De la Vega, R., & Miró, J. (2016). mHealth: A strategic field without a solid scientific soul. A systematic review of pain-related apps. PLoS One, 11(7), e0159960.
Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA, 315(15), 1624-1645.
Eccleston, C., Blyth, F. M., Dear, B. F., Fisher, E. A., Keefe, F. J., Lynch, M. E., ... & Williams, A. C. D. C. (2020). Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services. Pain, 161(5), 889-893.
Häuser, W., Schmutzer, G., Hilbert, A., Brähler, E., & Henningsen, P. (2014). Prevalence of chronic disabling noncancer pain and associated demographic and medical variables: a cross-sectional survey in the general German population. The Clinical Journal of Pain, 30(10), 861-872.
Jamison, R. N., Martel, M. O., Huang, C. C., Jurcik, D., & Edwards, R. R. (2013). Efficacy of the opioid compliance checklist to monitor chronic pain patients receiving opioid therapy in primary care. Journal of Pain and Symptom Management, 47(4), 752-761.
