Development of a digital intervention to optimise cancer pain control

Abstract

BackgroundPain is a frequent and distressing complication of cancer. Patients can have problems reporting pain, communicating about pain with professionals, using medications effectively, and seeking help.AimTo develop an intervention to support patients and professionals improve cancer pain control.MethodAn Intervention Mapping approach was taken to intervention development. Current challenges of managing cancer pain and potential solutions were investigated through systematic literature review and qualitative enquiries with patients, caregivers, and professionals. Behaviour change theory was applied systematically. A digital intervention was produced and prototypes were pre-tested. Patients were recruited with their linked Macmillan nurse and GP to feasibility test the intervention.ResultsA digital app was developed to help patients on strong opioids achieve personal treatment goals. The app includes a short film about pain management. It allows easy recording of short-acting analgesic doses, linked algorithmically to telephone help-screens. A weekly diary asks about pain, side effects, function, and medication adherence. App reports are automatically shared with linked professionals via NHS email. Early feasibility testing has been conducted with two patients, their linked GPs, and Macmillan nurses. Professionals found patient reports thought-provoking. Reports were used to inform clinical encounters, and seemed to promote a shared understanding of patient symptom management goals.ConclusionA digital intervention has been developed using a rigorous, theory-based methodological approach. There are early indications that the intervention could promote patient-centred care and shared decision making in patients with cancer pain. The intervention is ready to be tested on a larger scale.