# Examining the Feasibility and Effectiveness of an mHealth Solution Designed to Enhance Clinical Outcomes Among Patients Attending Physical Therapy for Musculoskeletal Pain

> **NIH AHRQ R21** · JOHNS HOPKINS UNIVERSITY · 2024 · $128,211

## Abstract

Musculoskeletal (MSK) pain is a major burden on the US population, representing the leading cause of disability
and non-cancer reason for opioids prescriptions, as well as the top health care spending category in the country.
Physical therapy (PT) has been shown to be effective in reducing pain and disability among patients with MSK
pain. PT has also been shown to help reduce health care spending related to MSK pain by reducing the utilization
of major cost drivers, such as imaging and surgery. However, the effects of PT are closely tied to patients’
engagement with PT care, especially how often they complete prescribed home exercises. Unfortunately, these
rates are often low, which means patients are not experiencing the full benefit of PT and are likely going on to
receive more invasive procedures or use opioids following a “non-response” to PT. In 2021, new procedural
codes were announced by the Centers for Medicare and Medicaid Services that facilitate the use of Remote
Therapeutic Monitoring (RTM) by physical therapists. RTM is a point of care mobile health (mHealth) solution
that includes the integration of a mobile application into the PT episode of care. Through the use of a digital RTM
platform, RTM allows physical therapists to assign exercises to patients in a mobile application, track their
adherence to home exercise programs, and to track patient progress through the use of patient-reported surveys
administered through the mobile application. While RTM stands to improve patients’ experiences with PT and
the effectiveness of PT, little to no research has been conducted on the effectiveness of RTM-enhanced PT nor
has research been conducted examining the feasibility of implementing RTM in health care systems. As such,
there is an urgent need for research examining the use of RTM among patients with MSK pain. To address this
gap, we propose a phased project (R21/R33) that will examine the feasibility, effectiveness, and implementation
of RTM at a large US academic health care system. During the R21 phase of the project, we will examine the
feasibility of implementing RTM among a pilot group of physical therapists that provide care for patients with
MSK pain (R21 Aim 1). We will also elicit feedback from these physical therapists and their patients receiving
RTM to refine our approach to delivering RTM (R21 Aim 2). Informed by our experiences during the R21 project
phase, the R33 project phase will include full-scale implementation of RTM among all MSK physical therapists
at our institution. During this project phase we will utilize routinely collected patient-reported data (i.e., PROMIS)
to examine the clinical effectiveness of RTM-enhanced PT compared to standard PT (R33 Aim 1), the influence
of RTM-enhanced PT on cost and downstream health care utilization (e.g., imaging, opioids) (R33 Aim 2), and
key implementation outcomes based on the RE-AIM framework. This study will represent one of the first studies
of RTM-enhanced PT and is lik...

## Key facts

- **NIH application ID:** 10952496
- **Project number:** 1R21HS030158-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Kevin McLaughlin
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $128,211
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10952496

## Citation

> US National Institutes of Health, RePORTER application 10952496, Examining the Feasibility and Effectiveness of an mHealth Solution Designed to Enhance Clinical Outcomes Among Patients Attending Physical Therapy for Musculoskeletal Pain (1R21HS030158-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10952496. Licensed CC0.

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