Digital health technologies may help with some aspects of pain management in older people

Bhattarai P, Phillips JL The role of digital health technologies in management of pain in older people: An integrative review Archives of Gerontology and Geriatrics. 2016 Jul; 68:14-24

Review question

• What are the features of digital health technology (DHT) in the management of pain in older people, is there evidence supporting its use, and what are the barriers and facilitators to its implementation?

Background

• Older people often face chronic pain due to conditions such as arthritis, osteoporosis and cancer. This chronic pain decreases quality of life and contributes to depression, reduced mobility and disability. In addition to difficult individual effects, these consequences contribute significantly to healthcare costs and lost productivity.
• DHT, such as medical or public health practices supported by mobile devices, can be used by older individuals to help manage their pain, such as by consulting mobile applications to seek health information online.
• This study aimed to assess whether DHT has the potential to effectively facilitate pain management in older people.

How the review was done

• A detailed search of five electronic databases for studies published up to and including August 2015 was conducted. Studies that focused on older people using DHT for pain management purposes were included.
• A total of 1,003 studies were identified in searches, and nine were included in the review after assessments for eligibility.
• The authors make no mention of a funding, financing or supporting source.

What the researchers found

• This review found that computer-based video interventions were the most common form of DHTs used. Video interventions that had an educational, interactive or instructional component were used most often. Amongst older people, educational video interventions were preferred.
• Overall, the review states that there is insufficient evidence to conclusively say DHTs are effective in managing pain in older patients. Despite this, the review found low-level evidence indicating that the use of DHTs could increase older patient ability to describe their pain. Additionally, watching pain management videos was associated with increased confidence in pain self-management, though these findings are somewhat inconclusive.
• This review also found that some barriers to implementation include concerns relating to the battery life of electronic devices. Older people also preferred to be trained on the device they are using, rather than have the device adjusted to their needs. A final facilitator that may support the implementation of these technologies is having open, close contact with clinicians.

Conclusion

• This review found some evidence supporting the use of DHTs to help with pain management in older people, particularly in increasing patient ability to describe their pain and increasing patient confidence in pain self-management. The review also found that the most common type of DHTs in pain management are computer-based interventions.