Abstract
Cancer-related pain in children is prevalent and undermanaged. Mobile health (mHealth) applications provide a promising avenue to address the gap in pain management in children with cancer. Pain Buddy is a multicomponent mHealth application developed to manage cancer-related pain in children. The goal of this paper is to present preliminary efficacy data of the impact of Pain Buddy on children's pain severity and frequency. In a randomized controlled trial over 60 days, children (N=48) reported daily pain on a tablet while receiving usual care. Those in the intervention group (N=20) received remote symptom monitoring and skills training for pain management. Children in the attention control group (N=28) only reported on their pain. Both groups experienced significant reductions in average daily pain over the study period (B=-0.10, z=-3.40, P=0.001), with no group differences evident (z=-0.83, P=0.40). However, the intervention group reported significantly fewer instances of moderate to severe pain compared with the control group, t(4125)=2.67, P=0.007. In addition, the intervention group reported no instances of moderate to severe pain toward the end of the study period. Pain Buddy is an innovative and interactive mHealth application that aims to improve pain and symptom management among children with cancer. The findings from this pilot study suggest that Pain Buddy may aid in the reduction of pain severity in children during cancer treatment.
Highlights
Over 10,000 children in the United States are diagnosed with cancer every year[1] and significant symptoms, such as recurrent pain, often accompany its treatment[2]
Under the conditions of this study, we found that children undergoing treatment for cancer experienced a decrease in pain severity over time, which did not differ between the intervention and attention control groups
Findings showed that children in the active intervention condition of Pain Buddy, that is, children who had access to remote symptom monitoring and cognitive and behavioral skills training for pain management evidenced significantly fewer moderate to severe pain episodes over the course of the 60-day study compared to children who only reported on their symptoms daily
Summary
Over 10,000 children in the United States are diagnosed with cancer every year[1] and significant symptoms, such as recurrent pain, often accompany its treatment[2]. In order to address the researchto-practice gap that has limited the translation of evidence-based strategies into the home setting[8], Pain Buddy incorporates coping skills shown to be effective in the management of pain, such as diaphragmatic breathing[9], progressive muscle relaxation[10], guided imagery[11], distraction[12], and mindfulness. Trainings for these skills can be accessed at any time and are linked to children’s symptom reports such that based upon symptom severity, duration, frequency, and/or distress, children are directed to the skills component of Pain Buddy. To overcome problems with lack of engagement that have limited the success of similar applications[13], Pain Buddy includes features such as a virtual store in which children can use coins accumulated during use of the skills training exercises to customize their personalized avatar and purchase additional background themes
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