During ancient times, people turned to shamans or sorcerers to deliver them from the throes of chronic pain, while today we turn to doctors dispensing opioid drugs, often powerful, frequently expensive, and in some cases, addicting.

In a new study, chronic pain patients enrolled in a year-long telecare program were twice as likely to see improvement as patients who received usual care (and the usual drugs) as treatment. "Our results demonstrate both the effectiveness of the telecare as well as the risk of patient deterioration in the absence of systematic approaches to optimizing pain therapy," said said Dr. Kurt Kroenke, a research scientist and professor at Indiana University School of Medicine professor of medicine.

Typical chronic ailments include headache, lower back pain, arthritis, and neuropathy. Although common, chronic pain is extremely difficult to treat and usually cannot be cured. Treatments generally include drugs, acupuncture, electrical stimulation, and, in some extreme cases, surgery. To understand the potential benefits of a new treatment strategy, Kroenke designed a study comparing usual care with telecare — collaborative care pain management delivered over the phone. The study enrolled 250 patients between the ages of 18 and 65 at the Richard L. Roudebush Veterans Affairs Medical Center clinic. Each participant had at least three months of chronic musculoskeletal pain of moderate or greater intensity.

Divided into two groups, participants received either usual pain care or telecare delivered by a participants' primary-care physician. Usual care patients simply received status quo treatment, including opioid pain relievers, from their primary care physician. Telecare patients received automated symptom monitoring, which was scheduled weekly for the first month, every other week for months two and three, and monthly for months four through 12. Monitoring happened through phone calls (51 percent of patients) or over the Internet (49 percent). Additionally, patients in this group also used non-opioid therapies, including five categories of non-addictive pain relievers, throughout the course of the study.

What did the researchers discover? The benefit of telecare did not vary by the age or race of the study participant, while both women and men were equally likely to benefit. Importantly, telecare patients reported greater satisfaction with their treatment regimen than those patients receiving usual care. However, Kroenke noted patience may be a key tool in a telecare program, as improvement was gradual over the 12-month period.

Source: Kroenke K, Krebs EE, Wang J, et al. Telecare Collaborative Management of Chronic Pain in Primary CareA Randomized Clinical Trial. Journal of the American Medical Association. 2014.