Abstract
BackgroundChronic pain imposes a large burden on individuals and society. A patient-centric digital chronic pain management app called Manage My Pain (MMP) can be used to enhance communication between providers and patients and promote self-management.ObjectiveThe purpose of this study was to evaluate the real-world engagement of patients in urban and rural settings in Ontario, Canada with the MMP app alongside their standard of care and assess the impact of its usage on clinical outcomes of pain and related mental health.MethodsA total of 246 participants with chronic pain at a rural and 2 urban pain clinics were recruited into this prospective, open-label, exploratory study that compared the use of MMP, a digital health app for pain that incorporates validated questionnaires and provides patients with summarized reports of their progress in combination with standard care (app group), against data entered on paper-based questionnaires (nonapp group). Participants completed validated questionnaires on anxiety, depression, pain catastrophizing, satisfaction, and daily opioid consumption up to 4.5 months after the initial visit (short-term follow-up) and between 4.5 and 7 months after the initial visit (long-term follow-up). Engagement and clinical outcomes were compared between participants in the two groups.ResultsA total of 73.6% (181/246) of the participants agreed to use the app, with 63.4% (111/175) of them using it for at least one month. Individuals who used the app rated lower anxiety (reduction in Generalized Anxiety Disorder 7-item questionnaire score by 2.10 points, 95% CI –3.96 to –0.24) at short-term follow-up and had a greater reduction in pain catastrophizing (reduction in Pain Catastrophizing Scale score by 5.23 points, 95% CI –9.55 to –0.91) at long-term follow-up relative to patients with pain who did not engage with the MMP app.ConclusionsThe use of MMP by patients with chronic pain is associated with engagement and improvements in self-reported anxiety and pain catastrophizing. Further research is required to understand factors that impact continued engagement and clinical outcomes in patients with chronic pain.Trial RegistrationClinicalTrials.gov NCT04762329; https://clinicaltrials.gov/ct2/show/NCT04762329
Highlights
MethodsSeveral large population-based surveys show that over 1 in 5 people live with chronic pain [1,2,3,4,5]
The use of Manage My Pain (MMP) by patients with chronic pain is associated with engagement and improvements in self-reported anxiety and pain catastrophizing
AThe nonapp group included data from the 65 participants who had declined to use the app at the start of the study and the 70 participants who initially accepted use of the app but either did not use the app or used it for less than 30 days. bGAD-7: Generalized Anxiety Disorder 7-item scale. cPHQ-9: Patient Health Questionnaire 9-item scale. dPDI: Pain Disability Index. ePCS: Pain Catastrophizing Scale. fOME: oral morphine equivalents
Summary
MethodsSeveral large population-based surveys show that over 1 in 5 people live with chronic pain [1,2,3,4,5]. The combined direct and indirect annual costs of chronic pain in North America are estimated to be more than US $650 billion [6,9,10,11] Despite these staggering numbers, there are barriers to improving the management and outcomes of chronic pain, including obtaining longitudinal data, assessing response to interventions, and addressing challenges to communication between patients and health care providers (HCPs) [12]. The need to maintain continuity of care for chronic pain patients has become imperative to avoid treatment disruptions due to public health emergencies, such as COVID-19, limiting in-person visits [13,14] To bridge this gap, a patient-centric digital health app can be used as a method of remote monitoring to enhance communication between patients and HCPs and promote self-management of patients’ symptoms. A patient-centric digital chronic pain management app called Manage My Pain (MMP) can be used to enhance communication between providers and patients and promote self-management
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