PRESS RELEASE: PAIN DOESN’T TAKE A HOLIDAY: PILOT STUDY REVEALS BREAKTHROUGH IN TACKLING CHRONIC PAIN

Program Addresses Pain Management and Getting Patients Back to Work

Chronic pain affects one in five Australians, with about a quarter of those reporting that pain has a serious impact on their mental health and the quality of their lives.

A Sydney-based medtech start-up, Amelio Health, has just completed a pilot study of people unable to return to work – finding that the 8 week program led to a reduction in opioid use of more than 60% and a 50% reduction in pain scores, anxiety, depression, fatigue and sleep disturbance.

And poor pain management is expensive. According to Deloitte Access Economics, the total financial cost of chronic pain in Australia in 2018 was estimated to be $73.2 billion, including $48.3 billion in productivity losses. And then there’s the addiction to pain killers…..The company has garnered the attention of insurance companies wanting to get people on Workcover back to work.

Amelio Health’s founder, Kathy Hubble, developed the program that provides a 24/7 health coach and weekly sessions individually tailored to the person, supported by a unique AI platform with data collected via wearable devices and patient feedback.

In May this year, the US National Institutes of Health, published a report revealing that, even when doctors can diagnose conditions that cause chronic pain, many aren’t equipped to treat it. And because pain is “nebulous” and varies from person to person, it can be difficult to pinpoint the appropriate treatments. The study also examined how pain progresses into chronic pain. Participants who experienced acute pain were more likely to develop chronic pain in the next year, with about one in six people with non-chronic pain reporting chronic pain a year later.

Kathy Hubble was a nurse for over 30 years, twenty of those working in pain management, largely in major teaching and trauma hospitals. She helped establish the Australian guidelines for pain management practice and has a master’s in pain medicine from the University of Newcastle.

From 2006 to 2013, Hubble worked as a clinical nurse consultant at Liverpool Hospital in Sydney. “One of the biggest problems we had at Liverpool, and was prevalent at other hospitals, were the long waiting lists for outpatient care for people suffering from chronic pain,” she said.

“It would often take up to three years for an initial consult with a pain management specialist.” The published wait times in 2012 were one to two years for appointments with Pain Specialists in Australia. The situation has worsened since 2012 due to an aging population, but surprisingly, the health system does not maintain long-term health data on chronic pain. (ePPOC is the national database that only includes short-term data). The wait times are much worse in rural and remote areas that are not served with Pain Specialists.

In the interim, patients would rely on their GPs, “who would treat pain with medications and refer their patients for interventions such as surgery or steroid injections,” Hubble said.

“But either the surgery doesn’t work, the injections cease to work after some time or the medications have side effects ranging from dependence to dangerous interactions with other medications and even suicidal ideation.”

A landmark series of papers in The Lancet in 2019, from researchers in Australia, the United States and Scotland, found that inappropriately managed post-surgery pain that becomes chronic and long-lasting is a major contributor to the global opioid epidemic.

Orthopaedic surgery is the third most common surgery in Australia, and in 2021 more than 100,000 orthopaedic surgeries were performed in Australian public hospitals. As most orthopaedic surgeries are performed in private hospitals, the real number is much higher (and unfortunately unknown).

In an article in The Conversation Professor Ian Harris from UNSW, and colleagues argued that there is evidence that commonly performed orthopaedic surgeries might be doing patients (and their pockets) more harm than good.

“Orthopaedic surgery (surgery for problems related to bones, joints, tendons and ligaments) is the third most common reason Australians go under the knife. But what most people don’t know is that many common orthopaedic surgeries are not better for reducing pain than non-surgical alternatives that are cheaper and safer, such as exercise programs. Some surgeries provide the same result as a placebo surgery, where the surgeon only conducts a joint examination rather than performing the real surgery,” the authors said.

Working at Liverpool Hospital, Hubble noticed that one of the few things that worked for pain management was teaching patients self-management tools to assist with their pain. “Behavioural tools such as CBT were clearly working when nothing else was,” Hubble said. But there were no studies or evidence to back up her intuitions.

Hubble started working for life insurance companies as a return-to-work specialist, using her experience in pain science and psychology. It was when Hubble worked for Munich Reinsurance, that she identified the need for programs to address a worsening social health problem and commercial challenge for insurance companies.

Hubble launched Amelio Health in January 2020 with the support of rehabilitation company Recovre and seed funding from Sydney Startup Hub, Boosting Female Founders.

In 2021, the company started their program, which to date has enrolled more than 100 participants, almost all referred by insurance companies who pay around $4000 for the 8-week program. Program results continue to see a reduction in opioid use of more than 60% and a 50% reduction in pain scores, anxiety, depression, fatigue and sleep disturbance.

The program is entirely personalised, with participants having access 24/7 to live health coaching and assistance. The use of a wearable device allows the health coach to monitor the patient’s sleep patterns, medication use, oxygen blood saturation and side effects, while a pain diary keeps track of the patient’s moods.

Each of the eight weeks is devoted to one module. Feedback from the diaries, wearable devices and discussions with the health coach – using AI – prompt how the coach directs and counsels the patient, “so its real-time, daily behavioural training.”

Importantly all of the program is done via remote video. “There’s no homework, all the learning modules are done by short videos, which we have shown have a much higher engagement rate,” Hubble said. The program covers areas such as nutrition, the evidence behind why medications don’t work long term, sleep and mood, resilience, managing flare-ups, preparing to return to work and reconnecting with the life you had before pain.

In late October, Hubble travelled to the US to talk with insurers in the US, followed by a presentation at the InsureTechConnect Conference, hosted by McKinsey and Company, in Las Vegas on October 31. Earlier this year, Amelio Health, was the only Australian company selected from seven worldwide for the Global Insurance Accelerator program, providing access and mentoring with the world’s biggest insurance companies.