Q&A: App helps patients manage chronic pain
An app can help patients with chronic pain improve their anxiety and pain catastrophizing, according to research published in JMIR mHealth and uHealth.
In the prospective, open-label, exploratory study, researchers compared the outcomes of patients with chronic pain who received usual care and used a mobile app or paper-based questionnaires to record their pain experiences.
The app, Manage My Pain, incorporates validated questionnaires and provides patients with summary reports of their progress.
A total of 246 patients who had been experiencing moderate-to-severe pain for at least 3 months and presented for care at one of three pain clinics — one rural and two urban — were included in the study.
Among these patients, 73.6% used the app, and 63.4% of them used it for at least a month.
The researchers determined that those who used the app had lower anxiety, with a 2.1-point (95% CI –3.96 to –0.24) reduction in Generalized Anxiety Disorder seven-item questionnaire score at short term follow up.
They also found that patients who used the app had a greater reduction in pain catastrophizing compared with those who did not use the app. Pain Catastrophizing Scale scores were reduced by 5.23 points (95% CI, –9.55 to –0.91) at long-term follow up.
Healio Primary Care spoke with Hance Clarke, MD, PhD, FRCPC, director of pain services and medical director of the pain research unit at University Health Network - Toronto General Hospital, to learn more about the findings and how the Manage My Pain app can help patients with chronic pain.
Healio: Why are solutions like the Manage My Pain app needed for patients with chronic pain?
Clarke: Chronic pain is a condition that waxes and wanes — it goes up and down from a severity standpoint. Manage My Pain gives patients the ability to track their pain severity and associated symptoms and empowers them to share their pain experiences. By tracking their pain, it also allows patients to reflect on the positive and negative aspects of their life and can hopefully enable a sense of control over their condition. In the clinic, engaged users often feel empowered to voice their concerns, which they feel over time hadn't been heard.
Healio: How does the app work?
Clarke: Every day, a reminder asks people to reflect on what meaningful activities they were able to accomplish in a given day. After focusing on the positives, the app then asks people to describe their pain experience. It takes less than a minute a day. This information can be played back through charts and graphs to highlight patterns and trends for both the patient managing his chronic pain and the health care practitioner in the clinic.
As a clinic, we can then monitor this progress remotely and intervene if indicated or simply use the information during our clinical visits.
Healio: Which patients would benefit most from using the app?
Clarke: A study was published that tried to understand which patients benefited the most from the app in terms of age, gender, medication use or medical condition. However, from my experience, I feel that anyone who has chronic pain and is trying to get a handle on how best to self-manage can benefit from the app. I have a patient who was struggling with a particular breast cancer medication and the medication itself intensified her pain — the app helped her to come to the realization that she needed a medication change. Others were able to identify times of the day/month that were particularly worse and implement coping strategies to improve their quality of life.
Healio: Is the app widely available for physician and patient use?
Clarke: Yes, anyone can download it on the Apple App Store or Google Play store. At University Health Network, we have an arrangement that enables all our patients to access a dedicated website, which enables a registration and a subscription version of the app at no cost. This is how our patients at the Toronto General Hospital are using the app and providing us updates regarding their progress in between visits.
Healio: Should hospitals and primary care practices in the U.S. consider using the app to help their patients with chronic pain manage their symptoms?
Clarke: Absolutely — anything that can help patients self-manage their condition while improving communication with their health care team is valuable. Given the COVID-19 pandemic and the large shift to virtual care, the Manage My Pain app has helped us navigate the transition from paper-based patient data collection — which is now no longer possible given we see 85% of patients virtually — and use the app to collect our clinic’s important patient-reported outcomes. In today’s virtual environment, most clinics have lost the ability to collect this important information. Luckily, we had this partnership prior to the pandemic and the relationship enabled the rapid transition from paper to an electronic medium relatively seamlessly.