Telemedicine Improves Pain-related Disabilities in Following up Cancer Pain Outpatient

Study Overview
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Brief Summary
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Cancer is the second leading cause of death worldwide, with approximately 18.1 million new cases and 9.6 million deaths reported in 2018. Cancer-related pain is experienced by 50-70% of patients, with a higher prevalence at advanced disease stages (66.4%). Since the development of WHO's cancer pain guidelines, several studies have reported good relief of symptoms and suffering for a majority of patients. Recent reports suggest that up to 50% of patients still report insufficient pain control. Patients with cancer often present with multiple symptoms and functional decline. Evidence supports multidisciplinary approaches to address symptoms and suffering, including early palliative care referral From review literatures we found that the telemedicine group had significantly higher quality of life than the usual care group. In addition, the telemedicine group had lower anxiety and depression scores than the usual care group. Therefore, we will conduct the non-randomized controlled study of using telemedicine comparing to conventional in-person at OPD in hospitalized cancer pain patients. The purpose of this study is to assess the pain interference by using the Brief Pain Inventory (BPI) and to compare between the in-person group and the telemedicine group. To assess the cost-effectiveness of telemedicine for reducing symptoms associated with cancer and its treatment.

Detailed Description
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The pain interference will be assessed and compared using Brief Pain Inventory from 0-70 between In-person group and telemedicine group at 1 month.

Official Title
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Telemedicine Improves Pain-related Disabilities in Following up Cancer Pain Outpatient: A Prospective Non-randomized Study.

Conditions
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Pain, Chronic, Cancer Pain

Intervention / Treatment
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* Other: Telemedicine
* Other: In-person


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age older than 18 years old Cancer patients who new visit as out patient at pain clinic, Siriraj hospital Exclusion Criteria: Cannot read and write Confusion Unable to use the 0-10 Numerical Rating Scale (NRS) to rate pain intensity. Unstable clinical presentation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: In-person<br>Face to face at OPD | Other: In-person<br>* In-person<br>|
| Experimental: Telemedicine<br>Telemedicine | Other: Telemedicine<br>* Telemedicine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain interference | The pain interference will be assessed and compared using Brief Pain Inventory from 0-70 between In-person group and telemedicine group. | at 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life (QoL) | The quality of life will be assessed and compared using EuroQoL 5D5L between In-person group and telemedicine group. | at 1 month | 
| Pain intensity | The pain reduction will be assessed and compared using numerical rating (NRS) from 0-10; 0 designating no pain and 10 designating  worst possible pain scale between In-person group and telemedicine group. | at 1 month, 2 months and 3 months |