Feasibility of Telemedicine for Cancer Pain Management: A Pragmatic Randomised Controlled Trial

Abstract

Objectives: To evaluate the feasibility of implementing telemedicine for cancer pain management through assessment of patient adherence, quality of life, and satisfaction with palliative care. Materials and Methods: Longitudinal open-label randomised controlled trial (n = 170). Participants were randomised to standard care or standard care plus 4-week telemedicine intervention after baseline in-person assessment using Brief Pain Inventory (BPI) (pain), EQ-5D-5L (QoL) and medication details. All participants received standardised World Health Organization-based pain education. Intervention included weekly teleconsultations with voice or video calls, preceded by short message service reminders, for Numerical Rating Scale (NRS)/pain-free interval assessment, medication details and side-effect monitoring. The primary outcome, medication adherence was assessed through pill counts and interviews; secondary outcomes included pain status, QoL and satisfaction through Telehealth Usability Questionnaire (TUQ). Data were analysed using linear mixed models. Baseline characteristics were comparable between the groups. Results: Overall medication adherence was 90.2%. Participants in the intervention group missed significantly fewer pills when non-adherent (4.40 vs. 11.69, p = 0.003). Pain interference improved significantly ( p = 0.036); breakthrough pain frequency reduced (28% vs. 40.9%, p = 0.011 for ≥5 episodes). Quality of life remained stable or improved in the intervention group, whereas it declined in the control group. (EuroQoL-Visual Analogue Scale +2.46 vs. −1.99, p = 0.049). Overall satisfaction was high, with 76.6% positive responses on the Telehealth Usability Questionnaire (TUQ). Conclusion: Structured telemedicine intervention alongside standard care improved medication adherence, functional pain outcomes and QoL over 4 weeks in cancer pain management in a limited-resource setting.