Feasibility and acceptability of remote administration of the cold pressor test.

Objective: Quantitative sensory testing is often used to investigate pain in the context of experimental and clinical research studies. However, many of the devices used for QST protocols are only available in resource rich environments, thereby inadvertently limiting the possible pool of participants. Development of remote protocols for appropriate QST measures has the potential to reduce barriers to participation in research. Methods: Participants with insomnia and Crohn's disease were recruited as part of a clinical trial. We adapted a remote version of the cold pressor test for use during telehealth-based study assessments. Herein, we present data from the baseline assessments including an assessment of feasibility and acceptability of the task. Results: 100% of participants (N = 28) were able to complete the remote cold pressor test using a combination of materials from their homes and mailed by the study team. Temperature changes during the test were minimal and fairly evenly balanced between increases and decreases. Correlations between submersion time and both general and disease specific pain trended toward significance. Conclusions: We demonstrated that a remote version of the cold pressor test is feasible and acceptable in a clinical population and provided a step-by-step protocol for administration to facilitate use in other studies.

The Real-World Global Use of Patient-Reported Outcomes for the Care of Patients With Inflammatory Bowel Disease.

Background: Many patient-reported outcomes (PROs) have been developed for inflammatory bowel disease (IBD) without recommendations for clinical use. PROs differ from physician-reported disease activity indices; they assess patients' perceptions of their symptoms, functional status, mental health, and quality of life, among other areas. We sought to investigate the current global use and barriers to using PROs in clinical practice for IBD. Methods: A cross-sectional survey was performed. An electronic questionnaire was sent to an international group of providers who care for patients with IBD. Results: There were 194 respondents, including adult/pediatric gastroenterologists, advanced practice providers, and colorectal surgeons from 5 continents. The majority (80%) use PROs in clinical practice, 65% frequently found value in routine use, and 50% frequently found PROs influenced management. Thirty-one different PROs for IBD were reportedly used. Barriers included not being familiar with PROs, not knowing how to incorporate PRO results into clinical practice, lack of electronic medical record integration, and time constraints. Most (91%) agreed it would be beneficial to have an accepted set of consistently used PROs. The majority (60%) thought that there should be some cultural differences in PROs used globally but that PROs for IBD should be consistent around the world. Conclusions: PROs are used frequently in clinical practice with wide variation in which are used and how they influence management. Education about PROs and how to use and interpret an accepted set of PROs would decrease barriers for use and allow for global harmonization.