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CompletedNCT03299556Updated Sep 19, 2024Results posted

Effect of Wearable Health Technology on Patients Treated for Chronic Pain at Geisinger Health System

An observational study in Chronic Pain, sponsored by Purdue Pharma LP. Completed at 1 site in United States. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by Purdue Pharma LP · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
420
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This is a proof of concept study to measure the effect of Wearable Health Technology (WHT), including the Apple Watch, iPhone, Pain App and Provider Dashboards on important clinical outcomes in patients treated for chronic pain. WHT will be tested in a group of chronic pain patients treated at a specialty pain clinic, the Geisinger Multidisciplinary Pain Program (MPP). Primary and secondary outcomes include pain, physical function, depression, pain medicine use, amount of sleep, activity levels, healthcare resource utilization and cost. The WHT will collect self-reported data on pain, pain management therapies, and medication utilization, and passively collected data on subject activity levels and sleep. Additional data will be collected on device utilization by patients and health care professionals.

Read the detailed description

This is a prospective, non-randomized, non-blinded trial with historic and concurrent controls to assess the effect of the addition of WHT on patient and health system outcomes. WHT used in this study are the Apple Watch and iPhone, a pain application (Pain App) designed specifically for this study to be used with the watch and phone, and physician and patient dashboards also designed for this study to provide subjects and health care providers data displays of information captured by the WHT.

The WHT will consist of:

  • AppleWatch and iPhone
  • Patient and provider tracking of patient-reported pain, pain management, medication usage, functionality, depression, activity and sleep (measured by 3 axis actigraph)
  • Prompts to subjects to engage in self-care, including non-pharmaceutical pain management therapies consistent with MPP training

Subjects will use the WHT 20 hours per day, every day for a period of 12 months.

Subjects will attend study visits at baseline and months 2, 4, 6, 8, 10 and 12.

Outcome data for control groups will be collected retrospectively from the electronic health record (EHR). Assessments will have occurred as part of their standard of care.

02

Conditions studied

  • Chronic Pain

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Keywords

  • Wearable Health Technology
  • iPhone
  • Apple Watch
  • Pain Medication
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Geisinger chronic pain patients, currently or previously enrolled in the MPP or currently receiving treatment in the MPM program.

Inclusion criteria

  • Admission to the MPP
  • Completion of the 3-day MPP training
  • Ability to understand and complete the informed consent form prior to the initiation of any study procedures
  • Adequate motor skills needed to utilize WHT
  • Willingness to utilize personal electronic devices and WHT, as expressed and documented during the informed consenting process
  • Ability to understand spoken and written English

Exclusion criteria

Exclusion Criteria:

  • Cancer diagnosis, AIDS, end-stage liver disease or end-stage renal disease
  • Hospitalization >30 days during the 12 months prior to Index Date
  • Nursing home or hospice care during the 12 months prior to Index Date
  • Presence of an EHR Diagnosis description "OPT-OUT CENTER RESEARCH" which indicates the subject has opted out of (i.e., does not wish to be included in) any Geisinger retrospective research
  • Has a terminated Medicine Use Agreement on their Problem List, indicator for substance abuse/dependence
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
420 participants (actual)
Patient registry
No

Groups and cohorts

  • WHT

    The WHT group includes only patients newly enrolled in the Geisinger MPP program who consent to participate in the study. WHT subjects will be recruited over 1 year, with 1 year of follow-up.

    Other: WHT

  • Historic Control

    Patients who were enrolled in the MPP in the preceding year. These patients received the MPP educational program but received no WHT as part of their treatment.

  • Concurrent Control

    Patients being treated for chronic pain in the Geisinger Medical Pain Management (MPM) program over the same time period as the WHT group. These subjects do not receive the MPP educational program nor use WHT as part of their treatment

Interventions

  • OtherWHT

    Incorporating WHT into treatment for chronic pain. WHT includes patient and provider tracking of patient-reported pain, pain management, medication usage, functionality, depression, activity and sleep (measured by 3 axis actigraph); as well as prompts to subjects to engage in self-care, including non-pharmaceutical pain management therapies consistent with MPP training.

05

What researchers measure

Primary outcomes

  1. Numerical Pain Score (NPS)

    self reported 11-point pain scale. The numeric pain score (NPS) is self-reported by the patient on a scale of 0 to 10, with the following scale labels: no pain (0), mild pain (2), moderate pain (4), severe pain (6), very severe pain (8), and worst pain possible (10).

    Time frame: Baseline, 12-month follow-up

  2. Patient Health Questionnaire (PHQ-9)

    self reported measurement of depression. The scale ranges from 0 to 27, indicating the following levels of depression severity: none (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27).

    Time frame: Baseline, 12-month follow-up

  3. Mean Daily Morphine Equivalents (MEQs)

    calculated from health records, average amount of daily pain medication \[as measured by the daily milligrams of morphine equivalents (MME)\].

    Time frame: Baseline, 12-month follow-up

Secondary outcomes

  1. Oswestry Disability Index (ODI)

    self reported measure of functionality, related to back and neck pain. The ODI is a self-administered questionnaire assessing symptoms and severity of back or neck pain on a scale from 0 to 100. This measurement evaluates the loss of function in activities of daily living. Two ODI questionnaires were used in this study, one for neck pain and one for back pain. Interpretation of ODI scoring is as follows: minimal disability (0-20), moderate disability (21-40), severe disability (41-60), and crippled (61-80). Scores over 80 suggest the patient may be bedbound or exaggerating their symptoms and careful evaluation is recommended.

    Time frame: Baseline, 12-month follow-up

Other outcomes

  1. Activity Levels (WHT Group Only)

    number of daily steps as measured by WHT application. Insufficient data collected for analysis of this outcome measure.

    Time frame: 12 months

  2. Sleep (WHT Group Only)

    quantity (hours) and quality as measured by WHT application. Insufficient data collected for analysis of this outcome measure.

    Time frame: 12 months

06

Results

Posted Sep 19, 2024

Participant flow

Participant flow — Overall Study
MilestoneWearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)
Started113146161
Completed105146161
Not completed800

Outcome measures

PrimaryNumerical Pain Score (NPS)

self reported 11-point pain scale. The numeric pain score (NPS) is self-reported by the patient on a scale of 0 to 10, with the following scale labels: no pain (0), mild pain (2), moderate pain (4), severe pain (6), very severe pain (8), and worst pain possible (10).

Time frame:
Baseline, 12-month follow-up
Reported as:
Mean · score on a scale
Numerical Pain Score (NPS)
score on a scaleWearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)
Baseline5.48 ± 1.506.50 ± 1.576.48 ± 1.70
12-month follow-up5.22 ± 1.536.10 ± 1.366.15 ± 1.54
PrimaryPatient Health Questionnaire (PHQ-9)

self reported measurement of depression. The scale ranges from 0 to 27, indicating the following levels of depression severity: none (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27).

Time frame:
Baseline, 12-month follow-up
Reported as:
Mean · score on a scale
Patient Health Questionnaire (PHQ-9)
score on a scaleWearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)
Baseline14.07 ± 5.6515.19 ± 6.3414.63 ± 4.90
12-month follow-up11.78 ± 6.1812.89 ± 6.2511.31 ± 5.73
PrimaryMean Daily Morphine Equivalents (MEQs)

calculated from health records, average amount of daily pain medication \[as measured by the daily milligrams of morphine equivalents (MME)\].

Time frame:
Baseline, 12-month follow-up
Reported as:
Mean · MME
Mean Daily Morphine Equivalents (MEQs)
MMEWearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)
Baseline51.38 ± 44.8456.83 ± 76.3043.42 ± 68.62
12-month follow-up38.36 ± 34.8854.46 ± 66.5143.69 ± 51.39
SecondaryOswestry Disability Index (ODI)

self reported measure of functionality, related to back and neck pain. The ODI is a self-administered questionnaire assessing symptoms and severity of back or neck pain on a scale from 0 to 100. This measurement evaluates the loss of function in activities of daily living. Two ODI questionnaires were used in this study, one for neck pain and one for back pain. Interpretation of ODI scoring is as follows: minimal disability (0-20), moderate disability (21-40), severe disability (41-60), and crippled (61-80). Scores over 80 suggest the patient may be bedbound or exaggerating their symptoms and careful evaluation is recommended.

Time frame:
Baseline, 12-month follow-up
Reported as:
Least squares mean · score on a scale
Oswestry Disability Index (ODI)
score on a scaleWearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)
ODI (Back) Baseline47.67 ± 13.5455.05 ± 12.4351.20 ± 11.78
ODI (Back) 12-month follow-up45.46 ± 14.3853.99 ± 12.9946.28 ± 16.74
ODI (Neck) Baseline50.07 ± 14.5159.23 ± 13.9653.10 ± 13.70
ODI (Neck) 12-month follow-up51.03 ± 14.5059.59 ± 13.7951.40 ± 17.27
Other pre-specifiedActivity Levels (WHT Group Only)

number of daily steps as measured by WHT application. Insufficient data collected for analysis of this outcome measure.

Time frame:
12 months

Results for this outcome have not been posted.

Other pre-specifiedSleep (WHT Group Only)

quantity (hours) and quality as measured by WHT application. Insufficient data collected for analysis of this outcome measure.

Time frame:
12 months

Results for this outcome have not been posted.

Adverse events

Collected over Adverse events were collected up to 12 months for participants in the WHT group. Up to a 12-month retrospective review of AE data was performed for the patients in the MPP and MPM control groups.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Wearable Health Tracker (WHT)0/113 (0%)0/113 (0%)0/113 (0%)
Historic Control (MPP)0/146 (0%)0/146 (0%)0/146 (0%)
Concurrent Control (MPM)0/161 (0%)0/161 (0%)0/161 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Wearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)Total
Mean50.1 ± 12.850.4 ± 11.847.1 ± 12.549.0 ± 12.4
Sex: Female, Male
Sex: Female, Male(Participants)Wearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)Total
Female8193110284
Male245351128
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Wearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)Total
Hispanic or Latino34815
Not Hispanic or Latino102142153397
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Wearable Health Tracker (WHT)Historic Control (MPP)Concurrent Control (MPM)Total
American Indian or Alaska Native0101
Asian0101
Native Hawaiian or Other Pacific Islander0000
Black or African American35917
White102139151392
More than one race0000
Unknown or Not Reported0011
07

Study locations

1 site
  • Geisinger Health System
    Danville, Pennsylvania 17822, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Sep 12, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03299556
Lead sponsor
Purdue Pharma LP
Collaborators
Geisinger Clinic
Responsible party
Sponsor
First posted
Oct 3, 2017
Start date
Oct 5, 2017
Primary completion
Nov 30, 2019
Completion
Nov 30, 2019
Results posted
Sep 19, 2024
Last update
Sep 19, 2024

Study contacts

Thomas Alfieri, PhD
study director · Purdue Pharma LP
John J Han, MD
principal investigator · Geisinger Clinic

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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