WASHINGTON—Wading through pages of pain diaries can be a tedious process for physicians. Technologies featured at the 2007 annual meeting of the American Pain Society may soon revolutionize the way pain is tracked and treated.

Robert N. Jamison, PhD, associate professor of anesthesiology and psychiatry at the Pain Management Center at Brigham and Women’s Hospital in Boston, presented preliminary results from a study comparing the use of paper diaries and handheld electronic diaries for tracking chronic noncancer pain (abstract 928). Patients (N=134) were randomized to use either of the two diary methods, and both the patients and 14 physicians completed questionnaires regarding the benefits or problems with the diaries.

The electronic diaries allowed patients to input pain levels during monthly visits over a 10-month period (Figure); they also tracked relief from medications, pain location, mood, activity interference and other variables. Patients also took the handheld devices home for one month to test their use away from the clinic.

Although comparison data to the paper diaries is still being collected, Dr. Jamison said that the majority of physicians (86%) thought electronic diaries could improve outcomes. Furthermore, 71% of physicians thought electronic monitoring in the clinic could prevent future problems, 79% felt it would help them better manage their patients, and 50% believed it could help reduce healthcare costs.

“The devices are now under $100,” said Dr. Jamison. “There is certainly some initial outlay of cost, but in another 10 years or so these devices will be even cheaper, the memory will be better.

“With paper diaries, the data often never gets entered or analyzed, but with electronic data there is instant access,” he told Pain Medicine News.

The software was developed as part of the National Institutes of Health–funded Small Business Innovation Research grant. More information on this software is available at www.neriscience.com.

Barry Eliot Cole, MD, executive director of the American Society of Pain Educators in Montclair, N.J., agreed that electronic tracking of pain and pain treatments will significantly improve care. “Dr. Jamison’s study proves again that electronic enhancements will become more and more integrated into mainstream healthcare, and not just pain management. For busy practitioners this is really going to make life a lot easier.”

Dr. Cole also noted that the ability to track medications and their effects may reinforce physicians’ accountability for prescribing practices. With clear electronic indications that a certain medication is not working, it will be much harder to simply keep prescribing that drug. “This kind of supportive documentation will make prescribing of controlled substances evolve to a higher standard,” he said.

Web-Based Diary

Another type of pain-tracking and management technology uses an Internet-based system that can be accessed from any computer rather than a specific device. Fred Eberlein is the founder and chief executive officer of ReliefInsite.com, which can provide real-time pain mapping and monitoring for pain patients. Because it works in real time, when a patient enters data on their pain at home or at any computer, the physician can immediately see the inputs made by the patient.

The service is compliant with the Health Insurance Portability and Accountability Act, and can create reports on patient pain, track medications and be tailored to specific practices or types of patients. “This is a more reliable, safer environment for data,” Mr. Eberlein said.

Dr. Cole said that any of these technological advancements would help healthcare evolve. “The future of medicine lies in every electronic enhancement we can get our hands on. Probably one or two minutes of analysis will replace 30 minutes of trying to understand data on paper. This will make for smarter and more efficient medical practices.”