945 lines
84 KiB
Text
945 lines
84 KiB
Text
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<meta name="description" content="The majority of digital therapeutics target disorders affecting the brain, such as substance use and pain. Read the director's message to learn more." />
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<title>Digital Interventions for Pain and Addiction | NIH HEAL Initiative</title>
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<li class="breadcrumb-item active is-active gtm-breadcrumb" aria-current="page">Digital Interventions for Pain and Addiction</li>
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<h1> Digital Interventions for Pain and Addiction </h1>
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<img loading="lazy" src="/files/heal_director_crop.jpg" width="873" height="700" alt="Rebecca G. Baker, Ph.D." class="img-fluid" />
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<figcaption class="figure-caption"> <p>Rebecca G. Baker, Ph.D., is the director of the NIH HEAL Initiative<sup>®</sup>. <a href="https://heal.nih.gov/about/director">Read more about Dr. Baker</a>.</p>
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<p>Now a commonplace term, the word “digital” originates from computer-based processes that operate according to the language of the digits 0 and 1. Digital tools are thus electronic versions of communication, measurement – and increasingly, tools for improving health. Digital tools offer both convenience (they go where we go) and precision (they can measure real-time output). Of interest to HEAL, according to a recent market analysis, the <a href="https://bluematterconsulting.com/prescription-digital-therapeutics-us-market-outlook-2023/">vast majority of digital therapeutics</a> target disorders affecting the brain, such as substance use, pain, and mental health conditions.</p>
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<p>Although digital interventions have been around for some time, they gained traction during the pandemic. As a result, interest and use in digital health tools has expanded. Ongoing HEAL research is thus important for providing evidence to guide use of effective technologies and to inform policies and insurance coverage. This month, I’ll talk about what we hope to learn from research testing digital interventions and why it’s an important focus for HEAL.</p>
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<h2>Digital Health Promotes a Whole Person Focus</h2>
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<p>For many people, mobile devices and apps let us access the internet anywhere, anytime (given good connectivity, which is still a significant problem across the country). HEAL researchers are developing and testing biological sensors, health coaches, and connections to peer support. Selected examples include:</p>
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<ul>
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<li>A user-friendly, home-based device <a href="https://reporter.nih.gov/project-details/9848428">uses specific smells to train the brain</a> how to minimize withdrawal symptoms and reduce drug cravings.</li>
|
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<li>A wearable sensor <a href="https://reporter.nih.gov/project-details/9545385">identifies signals of stress or drug use</a>, interfaces with a smartphone app, and provides real-time options for help and connection to treatment.</li>
|
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<li>A prescription digital therapy app <a href="https://reporter.nih.gov/project-details/10588517">delivers tangible rewards for desired behaviors</a>, offered in methadone treatment clinics to people who use cocaine.</li>
|
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<li>A <a href="https://reporter.nih.gov/project-details/10536567">trilingual telehealth pain coach mobile app</a> blends cognitive-behavioral therapy, physical therapy, mindfulness, and education about chronic pain management, and coordinates patient information with a health provider.</li>
|
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<li>A Bluetooth-based <a href="https://reporter.nih.gov/project-details/9848092">smart pill bottle cap</a> provides buprenorphine/naloxone dose reminders using a mobile app, text messages, and automated phone calls.</li>
|
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<li>A machine learning-enabled <a href="https://reporter.nih.gov/project-details/10485580">digital peer support program</a> added to an anonymous text-based social network provides 24/7 peer support for people at all stages of recovery.</li>
|
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</ul>
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<h2>Digital Interventions Help People See or Feel Things in a Different Way</h2>
|
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<p>Beyond convenience and flexibility, digital tools allow people to experience a range of outcomes safely, by providing a virtual platform. HEAL researchers are developing and testing educational video games, virtual reality, opportunity-based messaging, and others. Selected examples include:</p>
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<ul>
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<li><a href="https://reporter.nih.gov/project-details/9890338">PlaySmart</a> is a serious, yet highly engaging video game that uses simulated experiences to help teens and young adults consider outcomes of risky behavior in advance.</li>
|
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<li>Virtual reality devices are being tested for their ability to <a href="https://reporter.nih.gov/project-details/9848085">reduce the sensation of chronic back pain</a> (which may lead to lower opioid use), reduce pain by <a href="https://reporter.nih.gov/project-details/10216546">immersing patients in three-dimensional immersive environments</a> like walking up waterfalls, or to <a href="https://reporter.nih.gov/project-details/10390733">envision a personalized future</a> with or without drug use.</li>
|
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<li>An “<a href="https://reporter.nih.gov/project-details/9898052">artificial muscle</a>” for people with back pain is a robotic device with built-in feedback that monitors how a person is moving and adjusts tension to encourage and allow safe movement.</li>
|
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<li>A <a href="https://reporter.nih.gov/project-details/10013066">wearable device</a> collects and analyzes information using machine learning and artificial intelligence to predict when a patient is at risk for leaving treatment early or returning to drug use.</li>
|
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<li>A <a href="https://reporter.nih.gov/project-details/9855321">mobile tablet</a> given to teens and young adults during an emergency department visit offers routine HIV testing and counseling privately and discretely.</li>
|
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</ul>
|
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<h2>Digital Tools Help Researchers and Providers Be Accurate</h2>
|
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|
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<p>Another important use of digital tools is to advance research and improve clinical care with precise, unbiased collection of information. Selected examples include:</p>
|
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<ul>
|
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<li>A <a href="https://reporter.nih.gov/project-details/9898031">wearable monitor</a> measures and compares back and/or neck movement in people with low back pain disorders as well as in people with healthy spines, to identify predictive factors for low back pain.</li>
|
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<li>A <a href="https://reporter.nih.gov/project-details/9841017">wrist-worn sensor</a> detects motion, heart rate, skin surface temperature, and skin conductivity to help rate functional impairment from chronic pain.</li>
|
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<li>An in-depth <a href="https://reporter.nih.gov/search/bGpVOik3-USYmBgVzQ5TRA/project-details/10482203">digital training program</a> teaches addiction treatment counselors how to encourage friends and family members to help individuals seek treatment.</li>
|
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<li>A smartphone-based wireless device <a href="https://reporter.nih.gov/search/4ppvLm3F8EKmQxgUL8VJaA/project-details/10485389">monitors leg-abdominal muscle interactions</a> in real-time in women with chronic pelvic pain to guide home-based physical therapy.</li>
|
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<li>Decision-making tools embedded into electronic health records offer patients <a href="https://reporter.nih.gov/project-details/9876435">complementary and integrative pain treatment options</a> after surgery or <a href="https://clinicaltrials.gov/ct2/show/NCT03559179">advisories for providers</a> to identify people at high risk for developing opioid use disorder and offer treatment. </li>
|
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</ul>
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<p>For people with physical and emotional pain, digital interventions may appear to be a lifeline. Yet even for seemingly safe apps and devices, people (and providers) may not know about them or if they really work. Healthcare systems aren’t sure how to fit them into clinical workflows. Many people are concerned about privacy. For these and other reasons, the marketplace can be unpredictable, given unclear demand.</p>
|
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<p>The digital world is here to stay, and healthcare is adapting rapidly – some say too fast. As more and more products are developed for science and health applications – in particular for complex conditions like pain and addiction – there is a vital role for research to make sure these products are safe, and that they help people get better.</p>
|
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<p>Connect with us by email at <a href="/cdn-cgi/l/email-protection#4d05080c013c38283e392422230d222963232425632a223b"><span class="__cf_email__" data-cfemail="a2eae7e3eed3d7c7d1d6cbcdcce2cdc68ccccbca8cc5cdd4">[email protected]</span></a>, and subscribe to the NIH HEAL Initiative email list to get the monthly HEAL Digest sent directly to your inbox.</p>
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