Is There a Place for Mobile Apps in Managing Pain in Older Adults?

With mobile health technology becoming increasingly popular, more patients are willing to step out of their comfort zones to test out new ways to manage health indicators, and clinicians are more than willing to partner with them.

Success with using mobile technology to manage chronic pain in older adults depends on whether or not patients in this particular age group will use solutions provided to them by physicians. Fortunately, most baby boomers are comfortable using technology. Additionally, mobile device use is growing rapidly in patients older than 65. 

“Young adults and baby boomers are already well versed in using smartphones and other devices and are likely to be early adopters of the technologies when employed in the area of pain care,” said Cary Reid, MD, PhD, director of the Translational Research Institute on Pain in Later Life at Weill Cornell Medical College. “There is a perception that older adults (those aged 80 and older) are technologically challenged and will not use the devices. I believe this perception is another manifestation of ageism.”

Dr. Reid reported findings from his study that revealed more than 85% of older patients are willing to try mobile technology.1 Some of the barriers to use were battery life, costs, and concerns about privacy.

Dr. Reid told the audience that telemedicine is now being used in a variety of areas of medicine, and its use is increasing. Some of the available health-related apps include features such as biometric monitoring, data analysis and display functions, reminder prompts, and social support.

“Currently, 7 in 10 US adults use an electronic device to monitor a health indicator (eg, blood pressure, home glucose monitoring) for themselves or a loved one,” Dr. Reid said. “Use of the next wave of devices (smartphones, tablets, wearable sensors) continues to grow at a rapid pace. As of April 2015, two-thirds of all adults in the United States owned a smartphone compared with one in 3 in 2011. This number is expected to increase over time and smartphone ownership is growing fastest among older adults.”2

As more patients use electronic devices to monitor a health indicator, companies are trying to keep up with demand by developing new apps as often as possible.

“Mobile applications that work on phones or tablets are being produced at a very rapid rate,” Dr. Reid pointed out. “A recent review of the iTunes store revealed more than 200 applications for the management of pain alone. Another review of multiple app stores found more than 40,000 health-related apps.”

Compared with other types of health-related apps, pain management apps still have a long way to go. “Much work is being done to design systems where data generated by mobile devices are fed directly into electronic health records,” Dr Reid noted.

Pain app features could include input pain, pain interference, and mood levels. Apps might also include ways to analyze data and display results graphically, thus facilitating communication between patients and healthcare providers.

As to the question if clinicians will use mobile technology, Dr. Reid’s research indicates that more than 90% of primary care physicians are willing to at least try.3 Potential barriers to use include information overload, as well as liability and reimbursement issues.

“I would argue that telemedicine does not provide the same level of intimacy that comes from a face-to-face encounter, and therefore the quality of (and products emerging from) the encounter is not likely to be the same.”

“In addition, technology will never be able to supplant the ‘laying on of hands’ that remains a key component of delivering good clinical care,” Dr. Reid cautions. “Finally, conveying support, encouragement, empathy, and compassion—which are key parts of delivering care to patients struggling with any chronic illness—is always best done in person.”

References

1. Parker SJ, Jessel S, Richardson JE, Reid MC. Older adults are mobile too! Identifying the barriers and facilitators to older adults’ use of mHealth for pain management. BMC Geriatr. 2013;13:43. doi: 10.1186/1471-2318-13-43.

2. Pew Research Center. The Smartphone Difference.” April 2015. Available at: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/. Accessed August 20, 2015.

3. Levine M, Richardson JE, Granieri E, Reid MC. Novel telemedicine technologies in geriatric chronic non-cancer pain: primary care providers’ perspectives.  Pain Med. 2014;15:206-213.