Novel Telemedicine Technologies in Geriatric Chronic Non-Cancer Pain: Primary Care Providers’ Perspectives

Authors

  • Mimi Levine AB,

    1. Weill Cornell Medical College, New York, New York, USA
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  • Joshua E. Richardson PhD, MLIS, MS,

    1. Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, New York, USA
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  • Evelyn Granieri MD,

    1. Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
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  • M. Cary Reid MD, PhD

    Corresponding author
    1. Weill Cornell Medical College, New York, New York, USA
    2. Division of Geriatric Medicine and Aging, Columbia University, New York, New York, USA
    • Reprint requests to: Dr. M. Cary Reid, MD, PhD, Division of Geriatrics and Palliative Medicine, 525 E 68th Street, Box 39, Weill Cornell Medical College, New York, NY 10065, USA. Tel: 212-746-1729; Fax: 212-746-4888; E-mail: mcr2004@med.cornell.edu.

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  • Conflict of interest statement: Dr. Reid served as a consultant to Endo Pharmaceuticals in the past year. All other authors declare no conflicts of interest.
  • Funding sources: This research project was supported by grants from the American Federation for Aging Research sponsored Medical Student Training in Aging Research fellowship award, John A. Hartford Foundation, and a Edward R. Roybal Center for Translational Research on Aging Award (P30AG22845).
  • Authors' contributions: Mimi Levine and MC Reid designed and conducted the study. All authors (Levine, Richardson, Granieri, and Reid) participated in data analysis and interpretation. All authors also contributed to and approved the final draft of the manuscript.

Abstract

Objective

We sought to identify primary care providers' interest in, as well as perceived barriers and facilitators to, using novel telemedicine technologies (e.g., smartphones) for managing chronic non-cancer pain (CNCP) in older adults.

Design

Six focus groups were conducted with 25 primary care providers.

Setting

Two academically affiliated primary care practices serving older adults with CNCP in New York City.

Methods

The investigators used content analysis to analyze transcribed focus group data and identify specific themes.

Results

While most providers reported limited use of telemedicine, they expressed substantial interest in trying devices such as smartphones in the management of older patients with CNCP. Perceived barriers to implementation of telemedicine tools included information overload, lack of mobile device usability among patients and clinicians, liability issues, and cost. To overcome these barriers, participants suggested implementing electronic or human-based pre-analysis of data (e.g., a computer or a person that triages patient data), creating a low-cost and user-friendly mobile device design, and targeting appropriate user populations.

Conclusions

Primary care providers are interested in applying telemedicine when caring for older adults with CNCP. Although they perceived multiple barriers to device implementation, they offered innovative solutions to address these barriers. Providers felt that novel telemedicine technologies may improve the management of CNCP but wanted evidence that the devices were both cost- and time-efficient, and led to improved patient outcomes before adopting their use in practice.

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