Many pharmaceutical companies are now turning to digital tools to improve medication adherence, augment clinical trials, or develop parallel therapies with digital health companies. Rare is the pharmaceutical company that wants to actively get people to stop taking their medication, but that’s exactly the aim of a new study launched by Purdue Pharmaceuticals, maker of the blockbuster and subsequent national crisis-inducing opioid OxyContin.
Through a partnership the company instigated with Pennsylvania’s Geisinger Health System, Purdue is looking into how an iPhone and Apple Watch app can help people with chronic pain decrease their use of pain medication. Functioning as a digital add-on to Geisinger’s physical pain management clinics, the app will be used in a study that plans to enroll hundreds of patients and run for two years. More than 200 patients will be given Watches and iPhones to passively and actively track data ranging from physical activity and sleep to medication adherence and pain levels.
The goal of the ResearchKit study is to track how pain impacts the patient’s life and how medication is being used to manage it, which will hopefully provide insights on when and how alternative methods of pain management could be integrated into the patient’s care. By generating an ongoing report of how the patient is improving or worsening, doctors can step in recommend changes in their medication levels, or set goals to increase everyday activities or exercise.
While Pennsylvania is one of the hardest-hit states of the opioid crisis, the population the study is looking at does not include people who are in treatment for abuse of opioids. Rather, Purdue and Geisinger will enroll patients with chronic pain from conditions like osteoarthritis or back pain who currently take a range of medications, including non-opioids.
“What we are really looking at is whether we can we decrease pain, improve functioning and reduce reliance on pain medication,” Dr. Tracy Mayne, Purdue’s head of medical affairs strategic research told MobiHealthNews. “They aren’t all necessarily all taking opioids, but these are very sick patients with chronic pain and a lot of comorbidities, and I would be very surprised if even some of them haven’t been on pain medication for a long time.”
Mayne said Geisinger was chosen for its innovative pain management approach and comprehensive online patient portal, which will integrate all data from the study. The app will feature algorithms calculating when pain is going up or down along with mobility or medication usage, which will provide opportunities for members of that patient’s care team to reach out and make adjustments.
“Geisinger has a very cutting-edge biopsychosocial approach to chronic pain treatment, so we want to see if adding a digital component could make it even more successful,” Mayne said. “Plus, we needed to work with someone that has a patient and physician dashboard and has a pretty good idea of what goes into a remote monitoring program.”
Participants will be divided into four groups: the intervention group getting the Apple Watch and three comparison groups, which includes those that have been through Geisinger’s pain management treatment plan without the Watch, those who are in a standard pain clinic, and those who are only seeking treatment at a primary care clinic.
Mayne said the Watch was chosen because it is easy to integrate into a patient’s life, and ResearchKit paves the way to build onto the study in the future. He said Purdue has upped its digital health strategy after seeing the proliferation of wearable devices in healthcare innovation, but the company is also keenly aware of the high drop-off rate.
“That’s why we knew we had to integrate with a health system, because we’ve seen reports that people may get really excited about participating for a few months but then get bored and stop using it because they don’t see it impacting their care,” Mayne said. “What is happening in companies, a lot of them in Silicon Valley, is a lot of really interesting ideas like having a wristband that has your medical record stored in it. But if that doesn’t integrate into your care, it’s useless.”
Although the company has been accused of almost single-handedly sparking opioid abuse through aggressive, misleading advertising that led to over-prescribing and addiction, they are now trying to mitigate that collateral damage with a number of efforts to curb reliance on pain medication. Along with a number of non-opioid pain medications coming down the pipeline, Purdue is working on various programs to fight opioid abuse, such as a recent partnership to improve electronic prescription monitoring in Virginia and a sponsored epidemiology study in Oklahoma. Another study in North Carolina is looking into proper disposal of medication.
But the Geisinger study is much more upstream, as it is looking into ways to prevent abuse or reliance on pain medications from ever starting.
“This is part of a whole series of things going on, because we have to deal with pain differently,” said Mayne. “What are the non-medication things that we can be doing to improve treatment? That’s why we are going out there and looking at technology.”