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NCT Number: NCT05628246

Telemedicine Versus In-Person Follow-up for Cancer Pain Management: An Equity and Cost Analysis Comparison Using a Prospective Quasi-Experimental Design

Cancer is the second leading cause of death worldwide, with approximately 18.1 million new cases and 9.6 million deaths reported in 2018. Cancer-related pain is experienced by 50-70% of patients, with a higher prevalence at advanced disease stages (66.4%). Since the development of WHO's cancer pain guidelines, several studies have reported good relief of symptoms and suffering for a majority of patients. Recent reports suggest that up to 50% of patients still report insufficient pain control. Patients with cancer often present with multiple symptoms and functional decline. Evidence supports multidisciplinary approaches to address symptoms and suffering, including early palliative care referral

From review literatures we found that the telemedicine group had significantly higher quality of life than the usual care group. In addition, the telemedicine group had lower anxiety and depression scores than the usual care group.

Therefore, we will conduct the non-randomized controlled study of using telemedicine comparing to conventional in-person at OPD in hospitalized cancer pain patients.

The purpose of this study is to assess the pain interference by using the Brief Pain Inventory (BPI) and to compare between the in-person group and the telemedicine group. To assess the cost-effectiveness of telemedicine for reducing symptoms associated with cancer and its treatment.

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Key information

Conditions

Pain, Chronic Agnosia Cancer Pain Cancer Related Pain Chronic Pain Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Faculty of medicine Siriraj Hospital Mahidol University

Bangkoknoi, Bangkok, 10700, Thailand

About this study

The pain interference will be assessed and compared using Brief Pain Inventory from 0-70 between In-person group and telemedicine group at 1 month.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age older than 18 years old
  • Cancer patients who new visit as out patient at pain clinic, Siriraj hospital

Exclusion criteria

  • Cannot read and write
  • Confusion
  • Unable to use the 0-10 Numerical Rating Scale (NRS) to rate pain intensity.
  • Unstable clinical presentation

Treatment and study plan

Telemedicine

Other

Telemedicine

in-person

Other

In-person

Primary outcomes

  1. Pain interference

    Time frame: at 1 month

    The pain interference will be assessed and compared using Brief Pain Inventory from 0-70 between In-person group and telemedicine group.

Secondary outcomes

  1. Pain intensity

    Time frame: at 1 month, 2 months and 3 months

    The pain intensity from BPI (Brief Pain Inventory), including worst, least, average, and current pain reduction, will be assessed and compared using the numerical rating (NRS) from 0-10; 0 designating "no pain" and 10 designating " worst possible pain" scale between the in-person group and the telemedicine group.

  2. Quality of life (QoL)

    Time frame: at 1 month

    The quality of life will be assessed and compared using EuroQoL 5D5L between In-person group and telemedicine group.

  3. Functional status

    Time frame: At baseline, 1 month, 2 month, 3 month

    Functional status evaluated using Palliative Performance Status Score

  4. Opioid consumption

    Time frame: At baseline, 1 month, 2 month and 3 month

    Opioid consumption is recorded using the Morphine Equivalent Daily Dosage

  5. Economic study

    Time frame: At Baseline, 1 month, 2 month and 3 month

    We conducted an economic study evaluation from the patient and caregiver perspective. Costs analyzed included direct medical costs, direct non-medical costs (such as transportation and food), and indirect costs (total productivity loss). We calculated the Incremental Cost-Effectiveness Ratio (ICER) to determine the economic value of telemedicine relative to in-person care. The ICER was defined as the incremental difference in total direct costs divided by the incremental difference in clinical effectiveness across multiple outcomes, including EQ-5D-5L utility, EQ-VAS, PPS, total BPI reduction, and avoided increases in MEDD. The results were further visualized on a cost-effectiveness plane.

  6. Medication adverse effects

    Time frame: At baseline, 1-month, 2-month and 3-month

    Medication adverse effects such as sedation, constipation and nausea and vomiting were evaluated using the sedation score, Rome IV, and 4 point scale of nausea and vomiting.

Sponsors and collaborators

Lead sponsor

Mahidol University

Other

Registry information

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Nov 28, 2022
Registry last updated
Jul 21, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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