title: Evaluation of a standardized internet-based and telephone-based patient monitoring system for pain therapy with transdermal fentanyl.
abstract: The aim of the present observational 4-week study was to document the feasibility and utility of telephone-based or Internet-based pain monitoring in patients with chronic cancer or noncancer pain, such as nociceptive or neuropathic pain, using transdermal fentanyl. Pain intensity, treatment tolerability, activities of daily living, quality of life, and patient and physician satisfaction were evaluated in 60 (60% women, 42% opioid-naive) chronic pain patients who were switched from oral pain therapy to transdermal fentanyl therapy because of persisting severe pain. When the total dataset of all patient entries was analyzed, treatment with transdermal fentanyl led to decreases in maximal and mean pain scores as reported by the patients (-14% and -19%, respectively, last observation carried forward vs. baseline). Pain reduction was more pronounced in opioid-naive than in opioid-experienced patients (-35% and -25% vs. baseline, respectively; P=0.03). Overall, impairment of daily activities was reduced by 23% with transdermal fentanyl. No effect was observed with regard to quality of life and use of rescue pain medication. Transdermal fentanyl was generally well tolerated. Most patients (60%) preferred the telephone-based to the Internet-based or Internet combined with telephone questionnaires. Patient preference was driven by age, whereby younger patients tended to prefer the Internet and older patients the telephone (mean age, 45 and 54 y, respectively; difference n.s.). Internet-based and telephone-based monitoring of the efficacy and tolerability of opioid treatment for chronic pain was feasible in daily practice and generally well accepted by patients and physicians. Future research will determine the relative contribution of these 2 new options for patient-physician interaction and delineate their role in improving chronic pain control.
authors: Triemli City Hospital, 8063 Zurich, Switzerland. robert.theiler@triemli.stzh.ch
authors: Robert
authors: R
authors: Theiler
authors: Eli
authors: E
authors: Alon
authors: Stephan
authors: S
authors: Brugger
authors: André
authors: A
authors: Ljutow
authors: Thomas
authors: T
authors: Mietzsch
authors: Daniel
authors: D
authors: Müller
authors: Alexander
authors: A
authors: Ott
authors: Markus
authors: M
authors: Rimle
authors: André
authors: A
authors: Zemp
authors: Albert
authors: A
authors: Urwyler
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D016903:Drug Monitoring / Q000379:methods* / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D020407:Internet / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013689:Telephone / Q000592:standards* / Q000706:statistics & numerical data
chemical_list: D009294:Narcotics; D005283:Fentanyl