Optimising telehealth pain care after COVID-19.

Report by Professor Michael Nicholas, Director of the Pain Education Unit at the Pain Management Research Institute.

Dec 3, 2020

One of the positive outcomes of COVID-19 has been the rapid development of alternatives for our in-person pain management programs. We have had to develop these ‘telehealth programs’ since in-person programs were ceased in February this year.

The telehealth programs involve the same content as our ADAPT and Seniors programs, but delivered by a combination of methods, including a manual that can be emailed as a pdf to patients (or posted) – see the front cover image above – as well as a series of brief videos that show the patients how to perform the various skills and exercises. These are saved on Vimeo and accessible by a web-link sent to the participating patients as required.

The clinical psychologists and physiotherapists ‘see’ each patient individually (by telephone or videoconferencing) either weekly or fortnightly for a set number of sessions to guide them through the program.

The length and content of the program is individually tailored for each patient, but generally a ‘lite’ version comprises 5 sessions with each clinician, and the ‘regular’ version is up to 10 sessions each. However, these can be varied according to need.

Recently, we added a group version of the program where 5 patients attend simultaneously from home on their computer each week and the session is run like the in-person version with two staff for a 2 hour session.

Are these working? So far, our evaluations and feedback from the patients indicates this adapted format is very acceptable and effective. The patients report being pleased they don’t have to put themselves at risk by travelling to the hospital and staying in a local hotel. This also saves them financially and it has meant they can apply the skills taught at home from the start. Even when we resume our in-person programs, which we still think are needed for some patients, we plan to maintain the telehealth programs as well, and perhaps integrate them with the in-person versions. So, COVID-19 hasn’t been a complete disaster for pain management.