Original ArticlesEvaluation of a Standardized Internet-based and Telephone-based Patient Monitoring System for Pain Therapy With Transdermal FentanylTheiler, Robert MD, PD*; Alon, Eli MD†; Brugger, Stephan MD‡; Ljutow, André MD§; Mietzsch, Thomas MD*; Müller, Daniel MD∥; Ott, Alexander MD¶; Rimle, Markus PhD♯; Zemp, André MD‡; Urwyler, Albert MD‡Author Information *Triemli City Hospital, 8063 Zurich †University Hospital, 8091 Zurich ‡University Hospital, 4031 Basel §Swiss Paraplegic Centre, 6207 Nottwil ∥Medcontrol AG, 4415 Lausen ¶Cantonal Hospital; 9007 St Gallen ♯Janssen-Cilag AG, 6341 Baar, Switzerland Supported by an unrestricted educational grant from Janssen-Cilag AG, CH-6341 Baar, Switzerland. There is no conflict of interest. The corresponding author declares that there are no connections with the company (Medcontrol) that manufactures the product used in this investigation or with any firm that manufactures a competitive product. The presentation of the theme is independent and the content of the article is unbiased towards any product. Reprints: Robert Theiler, MD, PD, Department of Rheumatology, Physical Medicine and Rehabilitation, Triemli City Hospital, CH-8063 Zurich, Switzerland (e-mail: [email protected]). Received for publication April 2, 2007; revised July 7, 2007; accepted July 7, 2007 The Clinical Journal of Pain: November 2007 - Volume 23 - Issue 9 - p 804-811 doi: 10.1097/AJP.0b013e3181565d04 Buy Metrics Abstract The aim of the present observational 4-week study was to document the feasibility and utility of telephone-based or Internet-based pain monitoring in patients with chronic cancer or noncancer pain, such as nociceptive or neuropathic pain, using transdermal fentanyl. Pain intensity, treatment tolerability, activities of daily living, quality of life, and patient and physician satisfaction were evaluated in 60 (60% women, 42% opioid-naive) chronic pain patients who were switched from oral pain therapy to transdermal fentanyl therapy because of persisting severe pain. When the total dataset of all patient entries was analyzed, treatment with transdermal fentanyl led to decreases in maximal and mean pain scores as reported by the patients (−14% and −19%, respectively, last observation carried forward vs. baseline). Pain reduction was more pronounced in opioid-naive than in opioid-experienced patients (−35% and −25% vs. baseline, respectively; P=0.03). Overall, impairment of daily activities was reduced by 23% with transdermal fentanyl. No effect was observed with regard to quality of life and use of rescue pain medication. Transdermal fentanyl was generally well tolerated. Most patients (60%) preferred the telephone-based to the Internet-based or Internet combined with telephone questionnaires. Patient preference was driven by age, whereby younger patients tended to prefer the Internet and older patients the telephone (mean age, 45 and 54 y, respectively; difference n.s.). Internet-based and telephone-based monitoring of the efficacy and tolerability of opioid treatment for chronic pain was feasible in daily practice and generally well accepted by patients and physicians. Future research will determine the relative contribution of these 2 new options for patient-physician interaction and delineate their role in improving chronic pain control. © 2007 Lippincott Williams & Wilkins, Inc.