An app helps to improve pain control and reduce the use of opiates after surgery

Patients who underwent total knee arthroplasty and who used a smartphone application (PainCoach) at home after surgery routinely reduced the use of opioid badgesics and improved pain control, according to a report. new research presented at this year's Euroanaesthesia congress (annual meeting of the European Society of Anesthesiology) in Vienna, Austria (1-3 June).

The more study participants used the application, the more likely they were to reduce pain scores and decrease their opioid use.

"These findings are important given the current demands of the healthcare system and the increasing misuse of prescription painkillers around the world," says Dr. Amar Sheombar, author of Kliniek ViaSana in the Netherlands. "There are few clinically tested mobile apps with clear and measurable goals to guide patients in controlling pain and using opiates at home after surgery."

To investigate the effect of the PainCoach application on pain and opioid use, Dutch researchers randomly badigned 71 patients (aged 56 to 70 years) undergoing total joint replacement surgery. knee, usual care (38 patients) or usual care alone (33) first 2 weeks at home after surgery.

The mobile app allows patients to grasp their level of pain (no pain, endurable pain, unbearable pain or unbearable pain) – based on this information and the number of days after surgery, the patient is not able to get the pain. application offers advice on the use of drug relief, exercises or rest.

Questionnaires were used to establish opiate consumption (oxycodone) and resting pain levels, during physical activity and at night, as well as for the use of other drugs painkiller, experience of exercise, acceptance of pain, function and quality of life. Participants completed questionnaires preoperatively, daily for the first two weeks and after one month.

The amount of use of the application has also been recorded, with "active use" defined as at least 12 uses of the application over 2 weeks. During the study, the average pain score on the Visual Analog Scale (VAS) was 23 (the scale ranges from 0 to 100, 100 corresponding to the most intense pain) and the average opioid consumption in the group was less than half (0.4) of an oxycodone tablet at 5 mg per day. .

Compared to the control group, PainCoach application users used 23% less opiates and 15% more paracetamol during the first 2 weeks after surgery.

Regular (active) use of the application has led to further reduction in the use of opiates and better pain control during activity and at night. Regular users of applications (19 patients) reported a fourfold faster reduction of pain during activity, a sixfold faster night reduction, and a 44% reduction of opiates and 76% gabapentin (taken to relieve nerve pain) compared to controls. The use of opiates has been replaced by a 21% increase in paracetamol use among regular users of the applications.

"Knowing that we retain 80% of the interactive tips perhaps explains why regular use of the PainCoach app helps to reduce pain scores and the use of pain." 39; opiates, "says Dr. Sheombar. "Digital innovations such as smartphone health apps must empower patients to act and provide patient-centered care." Three-quarters of the study's patients found our app interesting and wanted use it for returns and support in real time.In the current study population, the use of opiates was already low: the application could have a much larger effect in populations of patients where preoperative opioid use is much higher. "

The long-term use of opioids can result in physical dependence and difficulty in discontinuing use. The misuse of prescription painkillers is a growing public health problem worldwide. In the United States, about 18 million Americans have misused prescribed painkillers at least once in the past year, and overdose deaths involving prescribed opioid pain medications were five times higher in 2016 than in 1999.

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