Joshua E. Richardson*, Weill Cornell Medical College, New York, United States M. Carrington Reid, Weill Cornell Medical College, New York, United States Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Oral presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: Auditorium Date: 2012-09-15 04:45 PM – 05:30 PM Last modified: 2012-09-12

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Chronic pain (CP) is a highly common, costly, and frequently disabling disorder among older adults. In 2011, the Institute of Medicine released a seminal report that called pain a major public health problem in the U.S. and noted that older adults constituted a particularly vulnerable population because of established disparities in pain management. Although analgesic medications remain the most commonly prescribed therapy among older adults for CP, concerns about untoward analgesic effects (by both patients and providers) constitute a major barrier to their use. One cause for these barriers is the inconsistent ways in which data are collected or, as is often the case, not collected. Providers who prescribe opioids rely heavily on their patients’ abilities to reliably collect accurate data about pain status and quality of life. Yet patient data that inform opioid medication management are traditionally recorded during patient visits, not while the patient is away from the office, and therefore offer providers an incomplete view of an opioid’s potential effectiveness and/or harm. This increases the chances of prescribing errors or may result in adverse events such as patient falls. Overcoming provider and patient barriers to analgesic medication use require novel means for accurately and reliably communicating information and coordinating care to help providers and patients better monitor opioids in the management of CP.

Mobile health technology (MHT) is flexible, adaptable, and increasingly affordable, and therefore represents a potentially powerful tool for supporting provider and older patient management of opioids to treat CP. In particular, MHT may provide new opportunities to collect clinical, patient lifestyle and patient behavior data that could foster enhanced provider-patient communication and care coordination. However, few MHTs exist that support communication and coordination to meet the needs of older patients with CP and providers alike. This represents a wide area of potential study for which there is great need yet for which little is known. We will therefore provide a needs assessment based on current peer-reviewed literature regarding use of MHT as a strategy to enhance communication and care coordination between providers and older patients with CP. First, we will present CP’s debilitating impact on the general population as a whole and on the older population in particular. Second, we will describe the needs that both older patients with CP and providers have for effectively communicating and coordinating care with one another. Third, based on these defined needs, we will describe potential MHT solutions such as mHealth applications or ubiquitous computing that could improve communication and care coordination in this setting. Toward this we will present some of our preliminary work that addresses the need for innovative MHT to improve communication and care coordination for older patients with CP and the providers who care for them. MHT holds substantial promise as tools to overcome communication and coordination barriers associated with the care of older patients with CP. This presentation will identify the areas where research and technological innovation can, and are beginning to, optimally address the need for improved CP care.