1
|
Solberg Nes L, Børøsund E, Varsi C, Eide H, Waxenberg LB, Weiss KE, Morrison EJ, Støle HS, Kristjansdottir ÓB, Bostrøm K, Strand EB, Hagen MCS, Stubhaug A, Schreurs KM. Living well with chronic pain: a 12-month randomized controlled trial revealing impact from the digital pain self-management program EPIO. Pain Rep 2024; 9:e1174. [PMID: 38962688 PMCID: PMC11221858 DOI: 10.1097/pr9.0000000000001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/03/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Chronic pain affects a wide range of physical and psychological aspects of life for those impacted. Psychosocial treatment approaches may be of support, but outreach is still limited. Objectives To evaluate the efficacy of EPIO, an evidence-informed, user-centered digital self-management intervention for people with chronic pain, in a 12-month randomized controlled trial. Methods People living with chronic pain (N = 266) were randomized to the EPIO intervention (n = 132) or a usual-care control group (n = 134). The intervention was delivered in a simple blended care model, and outcome measures collected at baseline, 6 months, and 12 months. Generalized linear models for repeated measures were fitted to compare groups over time. Results Participants were primarily female (81%), median age 49 years (range 22-78), with heterogeneous pain conditions, and had lived with pain >5 years (77.6%). A mixed linear model with all timepoints included revealed no statistically significant group differences for the primary outcome of pain interference. Significant psychological benefits in favor of the intervention group were however detected for depression (P = 0.022), self-regulatory fatigue (P = 0.024), vitality (P = 0.016), and mental health (P = 0.047). Baseline to 12-month changes showed additional favorable effects for anxiety (between-group mean differences [MDs] = 0.79, P = 0.047), depression (MD = 1.08, P = 0.004), self-regulatory fatigue (MD = 2.42, P = 0.021), pain catastrophizing (MD = 2.62, P = 0.009), and health-related quality of life. Conclusions The EPIO program aims to improve outreach of evidence-based pain self-management interventions. Findings demonstrate how using EPIO can lead to sustainable psychological change, enhancing mental health and health-related quality of life for people suffering from pain, providing a chance to live well with the pain.
Collapse
Affiliation(s)
- Lise Solberg Nes
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Elin Børøsund
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Cecilie Varsi
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lori B. Waxenberg
- Department of Clinical & Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Karen E. Weiss
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Eleshia J. Morrison
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Hanne Stavenes Støle
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Ólöf B. Kristjansdottir
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
- Mental Health Team West, Primary Care of the Capital Area, Reykjavik, Iceland
| | - Katrine Bostrøm
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
| | - Elin Bolle Strand
- Division of Medicine, Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Institute of Health, Faculty of Health Science, VID—Scientific University, Oslo, Norway
| | | | - Audun Stubhaug
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Regional Advisory Unit on Pain, Oslo University Hospital, Oslo, Norway
| | - Karlein M.G. Schreurs
- Department of Psychology, Health, and Technology, University of Twente, Enschede, Netherlands
| |
Collapse
|
2
|
Gasteiger N, Norman G, Grainger R, Eost-Telling C, Jones D, Ali SM, van der Veer SN, Ford CR, Hall A, Law K, Byerly M, Davies A, Paripoorani D, Shi C, Dowding D. Reporting quality of published reviews of commercial and publicly available mobile health apps (mHealth app reviews): a scoping review protocol. BMJ Open 2024; 14:e083364. [PMID: 38964792 PMCID: PMC11227806 DOI: 10.1136/bmjopen-2023-083364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/14/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Reviews of commercial and publicly available smartphone (mobile) health applications (mHealth app reviews) are being undertaken and published. However, there is variation in the conduct and reporting of mHealth app reviews, with no existing reporting guidelines. Building on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we aim to develop the Consensus for APP Review Reporting Items (CAPPRRI) guidance, to support the conduct and reporting of mHealth app reviews. This scoping review of published mHealth app reviews will explore their alignment, deviation, and modification to the PRISMA 2020 items for systematic reviews and identify a list of possible items to include in CAPPRRI. METHOD AND ANALYSIS We are following the Joanna Briggs Institute approach and Arksey and O'Malley's five-step process. Patient and public contributors, mHealth app review, digital health research and evidence synthesis experts, healthcare professionals and a specialist librarian gave feedback on the methods. We will search SCOPUS, CINAHL Plus, AMED, EMBASE, Medline, APA PsycINFO and the ACM Digital Library for articles reporting mHealth app reviews and use a two-step screening process to identify eligible articles. Information on whether the authors have reported, or how they have modified the PRISMA 2020 items in their reporting, will be extracted. Data extraction will also include the article characteristics, protocol and registration information, review question frameworks used, information about the search and screening process, how apps have been evaluated and evidence of stakeholder engagement. This will be analysed using a content synthesis approach and presented using descriptive statistics and summaries. This protocol is registered on OSF (https://osf.io/5ahjx). ETHICS AND DISSEMINATION Ethical approval is not required. The findings will be disseminated through peer-reviewed journal publications (shared on our project website and on the EQUATOR Network website where the CAPPRRI guidance has been registered as under development), conference presentations and blog and social media posts in lay language.
Collapse
Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
| | - Gill Norman
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Charlotte Eost-Telling
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
| | - Debra Jones
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
| | - Syed Mustafa Ali
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
- Centre for Health Informatics, Division of Informatics, Imaging & Data Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Sabine N van der Veer
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
- Centre for Health Informatics, Division of Informatics, Imaging & Data Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Claire R Ford
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
| | - Alex Hall
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
| | - Kate Law
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- The Christie Hospital NHS Trust, Manchester, UK
| | - Matthew Byerly
- The University of Kansas School of Medicine, Wichita, Kansas, USA
| | - Alan Davies
- Centre for Health Informatics, Division of Informatics, Imaging & Data Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Deborah Paripoorani
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
- EMERGING Research Team, Manchester Royal Infirmary, Manchester, UK
| | - Chunhu Shi
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
| | - Dawn Dowding
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, UK
| |
Collapse
|
3
|
Cargnin ZA, Schneider DG, de Souza MG, Vargas MADO, Tourinho FSV. Low back pain self-management mobile applications: a systematic review on digital platforms. Rev Esc Enferm USP 2024; 58:e20230326. [PMID: 38875500 PMCID: PMC11210980 DOI: 10.1590/1980-220x-reeusp-2023-0326en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/27/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVE To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults. METHOD A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality. RESULTS Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale. CONCLUSION Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.
Collapse
Affiliation(s)
- Zulamar Aguiar Cargnin
- Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | - Dulcinéia Ghizoni Schneider
- Universidade Federal de Santa Catarina, Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| | | | | | - Francis Solange Vieira Tourinho
- Universidade Federal de Santa Catarina, Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem, Florianópolis, SC, Brazil
| |
Collapse
|
4
|
Díaz-Mohedo E, Carrillo-León AL, Calvache-Mateo A, Ptak M, Romero-Franco N, Carlos-Fernández J. App-Mohedo®: A mobile app for the management of chronic pelvic pain. A design and development study. Int J Med Inform 2024; 186:105410. [PMID: 38507980 DOI: 10.1016/j.ijmedinf.2024.105410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/23/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Chronic Pelvic Pain (CPP) has been described as a public health priority worldwide, and it is among the most prevalent and costly healthcare problems. Graded motor imagery (GMI) is a therapeutic tool that has been successfully used to improve pain in several chronic conditions. GMI therapy is divided into three stages: laterality training (LRJT, Left Right Judgement Task), imagined movements, and mirror therapy. No tool that allows working with LRJT in pelvic floor has been developed to date. OBJECTIVE This research aims to describe the process followed for the development of a highly usable, multi-language and multi-platform mobile application using GMI with LRJT to improve the treatment of patients with CPP. In addition, this will require achieving two other goals: firstly, to generate 550 pelvic floor images and, subsequently, to carry out an empirical study to objectively classify them into different difficulty levels of. This will allow the app to properly organize and plan the different therapy sessions to be followed by each patient. METHODOLOGY For the design, evaluation and development of the app, an open methodology of user-centered design (MPIu + a) was applied. Furthermore, to classify and establish the pelvic floor images of the app in different difficulty levels, an observational, cross-sectional study was conducted with 132 volunteers through non-probabilistic sampling. RESULTS On one hand, applying MPIu+a, a total of 5 phases were required to generate an easy-to-use mobile application. On the other hand, the 550 pelvic floor images were classified into 3 difficulty levels (based on the percentage of correct answers and response time used by the participants in the classification process of each image): Level 1 (191 images with Accuracy = 100 % and RT = [0-2.5] seconds); Level 2 (208 images with Accuracy = 75-100 % and RT = [2.5-5] seconds); and Level 3 (151 images with Accuracy = 50-75 % and RT > 5 s). CONCLUSION App-Mohedo® is the first multi-platform, multi-language and easy-to-use mobile application that, through GMI with LRJT, and with an adequate bank of images classified into three levels of difficulty, can be used as a complementary therapeutic tool in the treatment of patients with CPP. This work can also serve as an example, model or guide when applying a user-centered methodology, as MPIu + a, to the development of other apps, especially in the field of health.
Collapse
Affiliation(s)
| | | | | | - Magdalena Ptak
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Poland
| | - Natalia Romero-Franco
- Department of Nursing and Physiotherapy. University of the Balearic Islands. Spain; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Juan Carlos-Fernández
- Department of Nursing and Physiotherapy. University of the Balearic Islands. Spain; Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| |
Collapse
|
5
|
Gumede SB, de Wit JBF, Venter WDF, Wensing AMJ, Lalla‐Edward ST. Intervention strategies to improve adherence to treatment for selected chronic conditions in sub-Saharan Africa: a systematic review. J Int AIDS Soc 2024; 27:e26266. [PMID: 38924296 PMCID: PMC11197966 DOI: 10.1002/jia2.26266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/23/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Evidence-based intervention strategies to improve adherence among individuals living with chronic conditions are critical in ensuring better outcomes. In this systematic review, we assessed the impact of interventions that aimed to promote adherence to treatment for chronic conditions. METHODS We systematically searched PubMed, Web of Science, Scopus, Google Scholar and CINAHL databases to identify relevant studies published between the years 2000 and 2023 and used the QUIPS assessment tool to assess the quality and risk of bias of each study. We extracted data from eligible studies for study characteristics and description of interventions for the study populations of interest. RESULTS Of the 32,698 total studies/records screened, 2814 were eligible for abstract screening and of those, 497 were eligible for full-text screening. A total of 82 studies were subsequently included, describing a total of 58,043 patients. Of the total included studies, 58 (70.7%) were related to antiretroviral therapy for HIV, 6 (7.3%) were anti-hypertensive medication-related, 12 (14.6%) were anti-diabetic medication-related and 6 (7.3%) focused on medication for more than one condition. A total of 54/82 (65.9%) reported improved adherence based on the described study outcomes, 13/82 (15.9%) did not have clear results or defined outcomes, while 15/82 (18.3%) reported no significant difference between studied groups. The 82 publications described 98 unique interventions (some studies described more than one intervention). Among these intervention strategies, 13 (13.3%) were multifaceted (4/13 [30.8%] multi-component health services- and community-based programmes, 6/13 [46.2%] included individual plus group counselling and 3/13 [23.1%] included SMS or alarm reminders plus individual counselling). DISCUSSION The interventions described in this review ranged from adherence counselling to more complex interventions such as mobile health (mhealth) interventions. Combined interventions comprised of different components may be more effective than using a single component in isolation. However, the complexity involved in designing and implementing combined interventions often complicates the practicalities of such interventions. CONCLUSIONS There is substantial evidence that community- and home-based interventions, digital health interventions and adherence counselling interventions can improve adherence to medication for chronic conditions. Future research should answer if existing interventions can be used to develop less complicated multifaceted adherence intervention strategies.
Collapse
Affiliation(s)
- Siphamandla Bonga Gumede
- Ezintsha, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Department of Interdisciplinary Social ScienceUtrecht UniversityUtrechtthe Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social ScienceUtrecht UniversityUtrechtthe Netherlands
- Centre for Social Research in HealthUNSWSydneyNew South WalesAustralia
| | - Willem D. F. Venter
- Ezintsha, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Annemarie M. J. Wensing
- Department of Medical MicrobiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
- Ndlovu Research ConsortiumElandsdoornSouth Africa
| | | |
Collapse
|
6
|
McCartney H, Main A, Ibrar M, Rai HK, Weir NM, Maguire R. Professional-Facing Digital Health Solutions for the Care of Patients With Chronic Pain: Protocol for a Systematic Scoping Review. JMIR Res Protoc 2024; 13:e51311. [PMID: 38441946 PMCID: PMC10951835 DOI: 10.2196/51311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Chronic pain is a highly prevalent condition and one of the most common reasons why people seek health care. As a result, chronic pain has a significant personal and economic burden. The COVID-19 pandemic has aggravated the situation for patients with chronic pain through increased risk factors (eg, anxiety or depression) as well as decreased access to health care. Digital health solutions to support people with chronic pain are becoming increasingly popular. Most of the research has focused on patient-facing digital health solutions, although it is clear that the involvement of health and care professionals is crucial in chronic pain care. Certainly, digital health solutions intended for the use of health and care professionals in the care of patients with chronic pain (ie, professional facing) exist, for example, for clinical decision support; however, no review has investigated the studies reporting these interventions. OBJECTIVE The overall aim of this scoping review is to identify the available professional-facing digital health solutions for the purpose of chronic pain management. The objectives of this review are to investigate the components, target populations, and user settings of the available professional-facing digital solutions; health and care professionals' perspectives on using digital health solutions (if reported); the methods in which the digital health solutions are developed; and the outcomes of using professional-facing digital health solutions. METHODS Databases including MEDLINE, Embase, CINAHL, PsycInfo, and Inspec will be searched for studies reporting professional-facing digital health solutions for chronic pain care, using a comprehensive search strategy developed for each of the specific databases. A total of 2 independent reviewers will screen the titles and abstracts for review inclusion and then conduct full-text screening. Any conflicts in study inclusion will be resolved by a third reviewer at each stage of the screening process. Following data extraction and quality assessment, a qualitative content analysis of the results will be conducted. This review will identify the available professional-facing digital health solutions for chronic pain management. The results of this review are likely to be heterogeneous in terms of content (ie, the digital solutions will serve a variety of purposes, settings, target populations, etc) and methods (ie, experimental and nonexperimental designs). RESULTS The review is expected to finish in March 2024 and published in the summer of 2024. CONCLUSIONS This protocol outlines the need for a scoping review to identify professional-facing digital health solutions for the management of chronic pain. Results from this review will contribute to the growing field of research into the utility of digital health for chronic pain management. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51311.
Collapse
Affiliation(s)
- Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Natalie McFayden Weir
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| |
Collapse
|
7
|
Merolli M, Francis JJ, Vallance P, Bennell KL, Malliaras P, Hinman RS. Evaluation of Patient-Facing Mobile Apps to Support Physiotherapy Care: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e55003. [PMID: 38437018 PMCID: PMC10949126 DOI: 10.2196/55003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by physiotherapists. A benefit of using apps is their ability to incorporate behavior change techniques (BCTs) that can optimize the effectiveness of physiotherapeutic interventions. Research continues to suggest that despite their importance, behavior change strategies are often missing in patient management. Evaluating mobile apps that physiotherapists can use to drive behavior change may inform clinical practice and potentially improve patient outcomes. Examining the quality of apps and exploring their key features that can support behavior change and physiotherapy care are important aspects of such an evaluation. OBJECTIVE The primary aim of this study was to describe the range of mobile apps in app stores that are intended for use by patients to support physiotherapy care. The secondary aims were to assess app quality, BCTs, and their behavior change potential. METHODS A systematic review of mobile apps in app stores was undertaken. The Apple App Store and Google Play were searched using a 2-step search strategy, using terms relevant to the physiotherapy discipline. Strict inclusion and exclusion criteria were applied: apps had to be intended for use by patients and be self-contained (or stand-alone) without the requirement to be used in conjunction with a partner wearable device or another plugin. Included apps were coded for BCTs using the Behavior Change Technique Taxonomy version 1. App quality was assessed using the Mobile App Rating Scale, and the App Behavior Change Scale was used to assess the app's potential to change behavior. RESULTS In total, 1240 apps were screened, and 35 were included. Of these 35 apps, 22 (63%) were available on both the Apple App Store and Google Play platforms. In total, 24 (69%) were general in their focus (eg, not condition-specific), with the remaining 11 (31%) being more specific (eg, knee rehabilitation and pelvic floor training). The mean app quality score (Mobile App Rating Scale) was 3.7 (SD 0.4) of 5 (range 2.8-4.5). The mean number of BCTs identified per app was 8.5 (SD 3.6). BCTs most frequently included in the apps were instruction on how to perform a behavior (n=32), action planning (n=30), and self-monitoring of behavior (n=28). The mean behavior change potential score (App Behavior Change Scale) was 8.5 (SD 3.1) of 21 (range 3-15). CONCLUSIONS Mobile apps available to support patient care received from a physiotherapist are of variable quality. Although they contain some BCTs, the potential for behavior change varied widely across apps. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29047.
Collapse
Affiliation(s)
- Mark Merolli
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Australia
| | - Jill J Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Patrick Vallance
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Service and Sport, La Trobe University, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Peter Malliaras
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Service and Sport, La Trobe University, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
8
|
Gunsilius CZ, Heffner J, Bruinsma S, Corinha M, Cortinez M, Dalton H, Duong E, Lu J, Omar A, Owen LLW, Roarr BN, Tang K, Petzschner FH. SOMAScience: A Novel Platform for Multidimensional, Longitudinal Pain Assessment. JMIR Mhealth Uhealth 2024; 12:e47177. [PMID: 38214952 PMCID: PMC10818247 DOI: 10.2196/47177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/03/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024] Open
Abstract
Chronic pain is one of the most significant health issues in the United States, affecting more than 20% of the population. Despite its contribution to the increasing health crisis, reliable predictors of disease development, progression, or treatment outcomes are lacking. Self-report remains the most effective way to assess pain, but measures are often acquired in sparse settings over short time windows, limiting their predictive ability. In this paper, we present a new mobile health platform called SOMAScience. SOMAScience serves as an easy-to-use research tool for scientists and clinicians, enabling the collection of large-scale pain datasets in single- and multicenter studies by facilitating the acquisition, transfer, and analysis of longitudinal, multidimensional, self-report pain data. Data acquisition for SOMAScience is done through a user-friendly smartphone app, SOMA, that uses experience sampling methodology to capture momentary and daily assessments of pain intensity, unpleasantness, interference, location, mood, activities, and predictions about the next day that provide personal insights into daily pain dynamics. The visualization of data and its trends over time is meant to empower individual users' self-management of their pain. This paper outlines the scientific, clinical, technological, and user considerations involved in the development of SOMAScience and how it can be used in clinical studies or for pain self-management purposes. Our goal is for SOMAScience to provide a much-needed platform for individual users to gain insight into the multidimensional features of their pain while lowering the barrier for researchers and clinicians to obtain the type of pain data that will ultimately lead to improved prevention, diagnosis, and treatment of chronic pain.
Collapse
Affiliation(s)
- Chloe Zimmerman Gunsilius
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Neuroscience Graduate Program, Department of Neuroscience, Brown University, Providence, RI, United States
- Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Joseph Heffner
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Sienna Bruinsma
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Madison Corinha
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
| | - Maria Cortinez
- Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Hadley Dalton
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Ellen Duong
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Joshua Lu
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Aisulu Omar
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Lucy Long Whittington Owen
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
| | - Bradford Nazario Roarr
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Kevin Tang
- Industrial Design, Rhode Island School of Design, Providence, RI, United States
| | - Frederike H Petzschner
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States
- Center for Digital Health, Brown University, Lifespan, Providence, RI, United States
| |
Collapse
|
9
|
Merolli M, Ahmed O, McCreesh K, Remedios L, Butler-Henderson K. Are physiotherapists expected to be competent in digital health practice? Meta-synthesis of international physiotherapy practice competency standards. Physiother Theory Pract 2024:1-12. [PMID: 38214509 DOI: 10.1080/09593985.2023.2299202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging. OBJECTIVE Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice. METHODS Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes. RESULTS Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities. CONCLUSIONS Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.
Collapse
Affiliation(s)
- Mark Merolli
- Centre for Health Exercise, and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Australia
- Centre for Digital Transformation of Health, University of Melbourne, Carlton, Australia
| | - Osman Ahmed
- Department of Physiotherapy, University Hospitals Dorset NHS Foundation Trust, Poole, UK
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Karen McCreesh
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Louisa Remedios
- Department of Physiotherapy, School of Health Sciences, University of Melbourne, Parkville, Australia
- Institute of Health and Wellbeing, Federation University, Parkville, Australia
| | | |
Collapse
|
10
|
Kang Y, Trewern L, Jackman J, Irani Nee Soni A, McCartney D. Chronic pain: supported self-management. BMJ 2024; 384:e072362. [PMID: 38167273 DOI: 10.1136/bmj-2022-072362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
| | - Louise Trewern
- British Pain Society (patient author)
- Physiotherapy Pain Association
- Get-Involved-Evolving Through Patient Experience Committee at Torbay Hospital Pain Service
- Live Well With Pain
| | - John Jackman
- Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
| | - Anushka Irani Nee Soni
- Division of Rheumatology, Mayo Clinic Florida
- FMRIB Pain Analgesia/Anaesthesia Imaging Neuroscience group
| | - David McCartney
- Oxford City Practice
- Medical Sciences Division, University of Oxford
| |
Collapse
|
11
|
Fernández-Gualda MÁ, Ariza-Vega P, Galiano-Castillo N, Tovar-Martín I, Ortiz-Comino L, Lozano-Lozano M, Fernández-Lao C. PaiNEd app. Assessing central sensitization in survivors of breast cancer: A reliability study. Digit Health 2024; 10:20552076241260150. [PMID: 38882256 PMCID: PMC11179517 DOI: 10.1177/20552076241260150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/22/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Pain is a common adverse event in survivors of breast cancer (sBCs). As there is no gold standard to assess pain experience predominantly related to central sensitization (CS) symptoms, we designed the PaiNEd app, which includes an algorithm to report whether patients are under predominant CS pain mechanisms. Objective We aimed to assess the reliability of the PaiNEd app to estimate whether sBC pain experience is predominantly related to CS symptoms. Methods An observational, descriptive reliability design was employed to assess the inter- and intrarater reliability of the PaiNEd app. This app includes an algorithm that considers the number of painful body parts and some questionnaires related to pain, such as the Numeric Pain-Rating Scale, the Brief Pain Inventory, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Central Sensitization Inventory (CSI). Results A total of 21 sBCs with persistent pain were recruited. We observe a general trend of close agreement between the paper-based and app-based formats (ICCs ranged between 0.802 and 0.972; Cronbach's alpha ranged between 0.797 and 0.971). Test-retest reliabilities were moderate to excellent (ICCs ranged between 0.510 and 0.941; Cronbach's alpha ranged between 0.499 and 0.938). The agreement between the categorization of the CS algorithm and the CSI (cut-off point ≥ 40 for CS symptoms) was 95.24%. Conclusion The PaiNEd app emerges as a robust tool for evaluating pain experience predominantly related to CS and pain-related symptoms in sBCs. Its demonstrated reliability not only bolsters its utility but also signifies its potential as a valuable asset for healthcare professionals engaged in pain education programs.
Collapse
Affiliation(s)
- Miguel Ángel Fernández-Gualda
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
- Department of Physical and Sport Education, PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Faculty of Sports Sciences, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Isabel Tovar-Martín
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Department of Radiation Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Lucía Ortiz-Comino
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
- Health Sciences Faculty (Melilla), University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| | - Carolina Fernández-Lao
- Biomedical Group (BIO277), Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, Ibs.GRANADA, Granada, Spain
- Sport and Health Research Center (IMUDs), Parque Tecnológico de la Salud, Granada, Spain
| |
Collapse
|
12
|
Hunter R, Beattie M, O'Malley C, Gorely T. Mobile apps to self-manage chronic low back pain: A realist synthesis exploring what works, for whom and in what circumstances. PEC INNOVATION 2023; 3:100175. [PMID: 38213759 PMCID: PMC10782115 DOI: 10.1016/j.pecinn.2023.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 01/13/2024]
Abstract
Objective Chronic low back pain places a significant burden on healthcare services and sufferers. Clinical guidelines state that it is a condition that requires self-management. This realist synthesis explores how a mobile app could help people to self-manage chronic low back pain. Method Six databases and several non-academic sources were searched. In addition, nineteen realist interviews were conducted with stakeholders. Sources were selected and appraised for relevancy, richness, and rigour. Data was coded with analytical memos making retroductive inferences. Causal explanations were presented in context-mechanism-outcome configurations to form three programme theories. Results Data from 57 sources was synthesised to create 16 context-mechanism-outcome configurations and presented as three refined programme theories. The findings suggest people need to feel believed before they will engage with a self-management app. For those who feel abandoned by the healthcare service, a self-management app for chronic low back pain can be a valuable source of ongoing support and reduce feelings of social isolation. Conclusion A self-management app, if introduced appropriately and as adjunct to care, can be an empowering tool to self-manage chronic low back pain. Innovation Using input from key stakeholders enhances our understanding of the hidden generative mechanisms underpinning a programme's success or failure.
Collapse
Affiliation(s)
- Rebecca Hunter
- Department Nursing and Midwifery, University of Highlands and Islands, Inverness, Scotland, United Kingdom
| | - Michelle Beattie
- Department Nursing and Midwifery, University of Highlands and Islands, Inverness, Scotland, United Kingdom
| | - Chris O'Malley
- Specialist Librarian (Learning and Information Services), University of Highlands and Islands, Inverness, Scotland, United Kingdom
| | - Trish Gorely
- Department Nursing and Midwifery, University of Highlands and Islands, Inverness, Scotland, United Kingdom
| |
Collapse
|
13
|
Turesson C, Liedberg G, Björk M. Evaluating the Clinical Use and Utility of a Digital Support App for Employees With Chronic Pain Returning to Work (SWEPPE): Observational Study. JMIR Hum Factors 2023; 10:e52088. [PMID: 38079212 PMCID: PMC10750230 DOI: 10.2196/52088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The digital app SWEPPE (sustainable worker, a digital support for persons with chronic pain and their employers) was developed to improve the support of people with chronic pain in their return-to-work process after sick leave and includes functions such as the action plan, daily self-rating, self-monitoring graphs, the coach, the library, and shared information with the employer. OBJECTIVE This study aims to describe the use of the smartphone app SWEPPE among people with chronic pain who have participated in an interdisciplinary pain rehabilitation program. METHODS This is a case study including 16 people participating in a feasibility study. The analyses were based on user data collected for 3 months. Quantitative data regarding used functions were analyzed with descriptive statistics, and qualitative data of identified needs of support from the employer were grouped into 8 categories. RESULTS Self-monitoring was used by all participants (median 26, IQR 8-87 daily registrations). A total of 11 (N=16, 69%) participants set a work-related goal and performed weekly evaluations of goal fulfillment and ratings of their work ability. In total, 9 (56%) participants shared information with their employer and 2 contacted the coach. A total of 15 (94%) participants identified a total of 51 support interventions from their employer. Support to adapt to work assignments and support to adapt to work posture were the 2 biggest categories. The most common type of support identified by 53% (8/15) of the participants was the opportunity to take breaks and short rests. CONCLUSIONS Participants used multiple SWEPPE functions, such as daily self-registration, goal setting, self-monitoring, and employer support identification. This shows the flexible nature of SWEPPE, enabling individuals to select functions that align with their needs. Additional research is required to investigate the extended use of SWEPPE and how employers use shared employee information.
Collapse
Affiliation(s)
- Christina Turesson
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Gunilla Liedberg
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
14
|
Blake H, Chaplin WJ, Wainwright E, Taylor G, McNamee P, McWilliams D, Abbott-Fleming V, Holmes J, Fecowycz A, Walsh DA, Walker-Bone K. The Web-Based Pain-at-Work Toolkit With Telephone Support for Employees With Chronic or Persistent Pain: Protocol for a Cluster Randomized Feasibility Trial. JMIR Res Protoc 2023; 12:e51474. [PMID: 37902814 PMCID: PMC10644198 DOI: 10.2196/51474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Chronic or persistent pain affects one's ability to work or be productive at work, generating high societal and economic burden. However, the provision of work-related advice and support for people with chronic pain is variable or lacking. The Pain-at-Work (PAW) Toolkit was cocreated with people who live with pain, health care professionals, and employers. It aims to increase knowledge about employee rights and how to access support for managing a painful chronic condition in the workplace and provides advice on lifestyle behaviors that facilitate the management of chronic pain. OBJECTIVE We aimed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing access to the PAW Toolkit and telephone support calls from an occupational therapist (PAW) with treatment as usual (ie, standard support from their employer). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, and safety of this digital workplace health intervention. We will assess the candidate primary and secondary outcomes' feasibility and test research processes for a definitive trial. METHODS This is an open-label, parallel 2-arm pragmatic feasibility cluster randomized controlled trial with exploratory health economics analysis and a nested qualitative interview study. We aim to recruit 120 participants from at least 8 workplace clusters (any type, >10 employees) in England. The recruitment of workplaces occurs via personal approach, and the recruitment of individual participants is web based. Eligible participants are vocationally active adults aged ≥18 years with internet access and self-reporting chronic pain interfering with their ability to undertake or enjoy productive work. A restricted 1:1 cluster-level randomization is used to allocate employment settings to PAW or treatment as usual; participants are unblinded to group allocation. Following site- and individual-level consent, participants complete a web-based baseline survey (time 0), including measures of work capacity, health and well-being, and health care resource use. Follow-up is performed at 3 months (time 1) and 6 months (time 2). Feasibility outcomes relate to recruitment; intervention fidelity (eg, delivery, reach, uptake, and engagement); retention; and follow-up. Qualitative evaluation (time 2) is mapped to the Capability, Opportunity, Motivation-Behavior model and will explore intervention acceptability to employees and employers, along with individual and contextual factors influencing the delivery and uptake of the intervention. RESULTS Ethics approval was obtained in March 2023. Trial recruitment began in June 2023. CONCLUSIONS The PAW Toolkit is the first evidence-based digital health intervention aimed at supporting the self-management of chronic or persistent pain at work. This study will inform the design of a definitive trial, including sample size estimation, approaches to cluster site identification, primary and secondary outcomes' selection, and the final health economic model. Findings will inform approaches for the future delivery of this digital health intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05838677; https://clinicaltrials.gov/study/NCT05838677. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51474.
Collapse
Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Wendy J Chaplin
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, United Kingdom
| | - Elaine Wainwright
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Gordon Taylor
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Paul McNamee
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Daniel McWilliams
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Jain Holmes
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Aaron Fecowycz
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - David Andrew Walsh
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Karen Walker-Bone
- School of Public Health and Preventive Medicine, Monash University, Australia, United Kingdom
| |
Collapse
|
15
|
Barreveld AM, Rosén Klement ML, Cheung S, Axelsson U, Basem JI, Reddy AS, Borrebaeck CAK, Mehta N. An artificial intelligence-powered, patient-centric digital tool for self-management of chronic pain: a prospective, multicenter clinical trial. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1100-1110. [PMID: 37104747 DOI: 10.1093/pm/pnad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/13/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To investigate how a behavioral health, artificial intelligence (AI)-powered, digital self-management tool affects the daily functions in adults with chronic back and neck pain. DESIGN Eligible subjects were enrolled in a 12-week prospective, multicenter, single-arm, open-label study and instructed to use the digital coach daily. Primary outcome was a change in Patient-Reported Outcomes Measurement Information Systems (PROMIS) scores for pain interference. Secondary outcomes were changes in PROMIS physical function, anxiety, depression, pain intensity scores and pain catastrophizing scale (PCS) scores. METHODS Subjects logged daily activities, using PainDrainerTM, and data analyzed by the AI engine. Questionnaire and web-based data were collected at 6 and 12 weeks and compared to subjects' baseline. RESULTS Subjects completed the 6- (n = 41) and 12-week (n = 34) questionnaires. A statistically significant Minimal Important Difference (MID) for pain interference was demonstrated in 57.5% of the subjects. Similarly, MID for physical function was demonstrated in 72.5% of the subjects. A pre- to post-intervention improvement in depression score was also statistically significant, observed in 100% of subjects, as was the improvement in anxiety scores, evident in 81.3% of the subjects. PCS mean scores was also significantly decreased at 12 weeks. CONCLUSION Chronic pain self-management, using an AI-powered, digital coach anchored in behavioral health principles significantly improved subjects' pain interference, physical function, depression, anxiety, and pain catastrophizing over the 12-week study period.
Collapse
Affiliation(s)
- Antje M Barreveld
- Department of Anesthesiology, Tufts University School of Medicine, Newton-Wellesley Hospital, Newton, MA 02462, United States
| | - Maria L Rosén Klement
- Department of Immunotechnology, Lund University, Lund 221 00, Sweden
- PainDrainer AB, Sheeletorget, Medicon Village, Lund 223 81, Sweden
| | - Sophia Cheung
- Office of Clinical Research, Newton-Wellesley Hospital, Newton, MA 02462, United States
| | - Ulrika Axelsson
- PainDrainer AB, Sheeletorget, Medicon Village, Lund 223 81, Sweden
| | - Jade I Basem
- Department of Anesthesiology, Division of Pain Management, Weill Cornell Medicine, New York, NY 10065, USA
| | - Anika S Reddy
- Department of Anesthesiology, Division of Pain Management, Weill Cornell Medicine, New York, NY 10065, USA
| | - Carl A K Borrebaeck
- Department of Immunotechnology, Lund University, Lund 221 00, Sweden
- PainDrainer AB, Sheeletorget, Medicon Village, Lund 223 81, Sweden
| | - Neel Mehta
- Department of Anesthesiology, Division of Pain Management, Weill Cornell Medicine, New York, NY 10065, USA
| |
Collapse
|
16
|
Bostrøm K, Børøsund E, Eide H, Varsi C, Kristjansdottir ÓB, Schreurs KMG, Waxenberg LB, Weiss KE, Morrison EJ, Stavenes Støle H, Cvancarova Småstuen M, Stubhaug A, Solberg Nes L. Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial. J Med Internet Res 2023; 25:e47284. [PMID: 37624622 PMCID: PMC10492177 DOI: 10.2196/47284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/23/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Chronic pain conditions involve numerous physical and psychological challenges, and while psychosocial self-management interventions can be of benefit for people living with chronic pain, such in-person treatment is not always accessible. Digital self-management approaches could improve this disparity, potentially bolstering outreach and providing easy, relatively low-cost access to pain self-management interventions. OBJECTIVE This randomized controlled trial aimed to evaluate the short-term efficacy of EPIO (ie, inspired by the Greek goddess for the soothing of pain, Epione), a digital self-management intervention, for people living with chronic pain. METHODS Patients (N=266) were randomly assigned to either the EPIO intervention (n=132) or a care-as-usual control group (n=134). Outcome measures included pain interference (Brief Pain Inventory; primary outcome measure), anxiety and depression (Hospital Anxiety and Depression Scale), self-regulatory fatigue (Self-Regulatory Fatigue 18 scale), health-related quality of life (SF-36 Short Form Health Survey), pain catastrophizing (Pain Catastrophizing Scale), and pain acceptance (Chronic Pain Acceptance Questionnaire). Linear regression models used change scores as the dependent variables. RESULTS The participants were primarily female (210/259, 81.1%), with a median age of 49 (range 22-78) years and a variety of pain conditions. Analyses (n=229) after 3 months revealed no statistically significant changes for the primary outcome of pain interference (P=.84), but significant reductions in the secondary outcomes of depression (mean difference -0.90; P=.03) and self-regulatory fatigue (mean difference -2.76; P=.008) in favor of the intervention group. No other statistically significant changes were observed at 3 months (all P>.05). Participants described EPIO as useful (ie, totally agree or agree; 95/109, 87.2%) and easy to use (101/109, 92.7%), with easily understandable exercises (106/109, 97.2%). CONCLUSIONS Evidence-informed, user-centered digital pain self-management interventions such as EPIO may have the potential to effectively support self-management and improve psychological functioning in the form of reduced symptoms of depression and improved capacity to regulate thoughts, feelings, and behavior for people living with chronic pain. TRIAL REGISTRATION ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104.
Collapse
Affiliation(s)
- Katrine Bostrøm
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Ólöf Birna Kristjansdottir
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
- Mental Health Team West, Primary Care of the Capital area, Reykjavik, Iceland
| | - Karlein M G Schreurs
- Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
| | - Lori B Waxenberg
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Karen E Weiss
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| | - Eleshia J Morrison
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| | - Hanne Stavenes Støle
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Audun Stubhaug
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Regional Advisory Unit on Pain, Oslo University Hospital, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
17
|
Ali SM, Lee RR, McBeth J, James B, McAlister S, Chiarotto A, Dixon WG, van der Veer SN. Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study. JMIR Hum Factors 2023; 10:e42177. [PMID: 36753324 PMCID: PMC9947768 DOI: 10.2196/42177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Culture and ethnicity influence how people communicate about their pain. This makes it challenging to develop pain self-report tools that are acceptable across ethnic groups. OBJECTIVE We aimed to inform the development of cross-culturally acceptable digital pain self-report tools by better understanding the similarities and differences between ethnic groups in pain experiences and self-reporting needs. METHODS Three web-based workshops consisting of a focus group and a user requirement exercise with people who self-identified as being of Black African (n=6), South Asian (n=10), or White British (n=7) ethnicity were conducted. RESULTS Across ethnic groups, participants shared similar lived experiences and challenges in communicating their pain to health care professionals. However, there were differences in beliefs about the causes of pain, attitudes toward pain medication, and experiences of how stigma and gender norms influenced pain-reporting behavior. Despite these differences, they agreed on important aspects for pain self-report, but participants from non-White backgrounds had additional language requirements such as culturally appropriate pain terminologies to reduce self-reporting barriers. CONCLUSIONS To improve the cross-cultural acceptability and equity of digital pain self-report tools, future developments should address the differences among ethnic groups on pain perceptions and beliefs, factors influencing pain reporting behavior, and language requirements.
Collapse
Affiliation(s)
- Syed Mustafa Ali
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Rebecca R Lee
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - John McBeth
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | | | | | - Alessandro Chiarotto
- Department of General Practice, Erasmus University Medical Center, Rotterdam, Netherlands
| | - William G Dixon
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
18
|
Buis L, Moral-Munoz JA, Salazar A, Failde I. mHealth Intervention for Improving Pain, Quality of Life, and Functional Disability in Patients With Chronic Pain: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e40844. [PMID: 36729570 PMCID: PMC9936365 DOI: 10.2196/40844] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/24/2022] [Accepted: 12/14/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Chronic pain (CP) is 1 of the leading causes of disability worldwide and represents a significant burden on individual, social, and economic aspects. Potential tools, such as mobile health (mHealth) systems, are emerging for the self-management of patients with CP. OBJECTIVE A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional treatment or nonintervention. METHODS PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to conduct a systematic review of randomized controlled trials (RCTs) published in PubMed, Web of Science, Scopus, and Physiotherapy Evidence Database (PEDro) databases from February to March 2022. No filters were used. The eligibility criteria were RCTs of adults (≥18 years old) with CP, intervened with mHealth systems based on mobile apps for monitoring pain and health-related outcomes, for pain and behavioral self-management, and for performing therapeutic approaches, compared to conventional treatments (physical, occupational, and psychological therapies; usual medical care; and education) or nonintervention, reporting pain intensity, QoL, and functional disability. The methodological quality and risk of bias (RoB) were assessed using the Checklist for Measuring Quality, the Oxford Centre for Evidence-Based Medicine Levels of Evidence, and the Cochrane RoB 2.0 tool. RESULTS In total, 22 RCTs, involving 2641 patients with different CP conditions listed in the International Classification of Diseases 11th Revision (ICD-11), including chronic low back pain (CLBP), chronic musculoskeletal pain (CMSP), chronic neck pain (CNP), unspecified CP, chronic pelvic pain (CPP), fibromyalgia (FM), interstitial cystitis/bladder pain syndrome (IC/BPS), irritable bowel syndrome (IBS), and osteoarthritis (OA). A total of 23 mHealth systems were used to conduct a variety of CP self-management strategies, among which monitoring pain and symptoms and home-based exercise programs were the most used. Beneficial effects of the use of mHealth systems in reducing pain intensity (CNP, FM, IC/BPS, and OA), QoL (CLBP, CNP, IBS, and OA), and functional disability (CLBP, CMSP, CNP, and OA) were found. Most of the included studies (18/22, 82%) reported medium methodological quality and were considered as highly recommendable; in addition, 7/22 (32%) studies had a low RoB, 10/22 (45%) had some concerns, and 5/22 (23%) had a high RoB. CONCLUSIONS The use of mHealth systems indicated positive effects for pain intensity in CNP, FM, IC/BPS, and OA; for QoL in CLBP, CNP, IBS, and OA; and for functional disability in CLBP, CMSP, CNP, and OA. Thus, mHealth seems to be an alternative to improving pain-related outcomes and QoL and could be part of multimodal strategies for CP self-management. High-quality studies are needed to merge the evidence and recommendations of the use of mHealth systems for CP management. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022315808; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315808.
Collapse
Affiliation(s)
| | - Jose A Moral-Munoz
- Observatory of Pain, University of Cádiz, Cádiz, Spain.,Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain.,Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), Cádiz, Spain
| | - Alejandro Salazar
- Observatory of Pain, University of Cádiz, Cádiz, Spain.,Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Inmaculada Failde
- Preventive Medicine and Public Health Area, Department of Biomedicine, Biotechnology and Public Health, University of Cádiz, Cádiz, Spain.,Observatory of Pain, University of Cádiz, Cádiz, Spain.,Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), Cádiz, Spain
| |
Collapse
|
19
|
Trépanier LC, Lamoureux É, Bjornson SE, Mackie C, Alberts NM, Gagnon MM. Smartphone apps for menstrual pain and symptom management: A scoping review. Internet Interv 2023; 31:100605. [PMID: 36761398 PMCID: PMC9905939 DOI: 10.1016/j.invent.2023.100605] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
The past decade marks a surge in the development of mobile apps used to digitally track and monitor aspects of personal health, including menstruation. Despite a plethora of menstruation-related apps, pain and symptom management content available in apps has not been systematically examined. The objective of this study was to evaluate app characteristics, overall quality (i.e., engagement, functionality, design aesthetics, and information), nature and quality of pain and symptom tracking features, and availability and quality of pain-related intervention content. A scoping review of apps targeting facets of the menstrual experience was conducted by searching the Apple App Store. After removal of duplicates and screening, 119 apps targeting menstrual experiences were retained. Pain and menstrual symptoms tracking were available in 64 % of apps. Checkboxes or dichotomous (present/absent) reporting was the most common method of tracking symptoms and was available in 75 % of apps. Only a small subset (n = 13) of apps allowed for charting/graphing of pain symptoms across cycles. Fourteen percent of apps included healthcare professionals or researchers in their development and one app reported use of end-users. Overall app quality measured through the Mobile App Rating Scale (MARS) was found to be acceptable; however, the apps ability to impact pain and symptom management (e.g., impact on knowledge, awareness, behaviour change, etc.) was rated as low. Only 10 % of apps (n = 12) had interventions designed to manage pain. The findings suggest that despite pain and symptom management content being present in apps, this content is largely not evidence-based in nature. More research is needed to understand how pain and symptom management content can be integrated into apps to improve user experiences.
Collapse
Affiliation(s)
- Lindsey C.M. Trépanier
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Sarah E. Bjornson
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cayley Mackie
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nicole M. Alberts
- Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Michelle M. Gagnon
- Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, SK, Canada,Corresponding author at: University of Saskatchewan, Department of Psychology and Health Studies, 9 Campus Drive, Arts 154, Saskatoon, Saskatchewan, S7N 5A5, Canada.
| |
Collapse
|
20
|
Shade MY, Hama RS, Eisenhauer C, Khazanchi D, Pozehl B. "Ask, 'When You Do This, How Much Pain Are You In?'": Content Preferences for a Conversational Pain Self-Management Software Application. J Gerontol Nurs 2023; 49:11-17. [PMID: 36594917 DOI: 10.3928/00989134-20221205-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of the current study was to examine older adults' preferences for conversational pain management content to incorporate in an interactive application (app) for pain self-management. Conversational statements and questions were written as a script to encourage evidence-based pain self-management behaviors. The content was converted from text to female chatbot speech and saved as four groups of MP3 files. A purposive sample of 22 older adults participated in a guided interaction through the MP3 files. One-on-one interviews were conducted to garner participants' conversational content preferences. Overall, participants want the conversational content to increase health care provider engagement in pain management communication. Older adults preferred the inclusion of conversational statements and questions for monitoring the multifaceted dimensions of pain, treatment accountability, guidance for alternative treatments, and undesirable effects from pain treatments. The design of mobile health apps must incorporate the needs and preferences of older adults. [Journal of Gerontological Nursing, 49(1), 11-17.].
Collapse
|
21
|
Ali SM, Selby DA, Bourke D, Bravo Santisteban RD, Chiarotto A, Firth J, James B, Parker B, Dixon WG, van der Veer SN. Feasibility and acceptability to use a smartphone-based manikin for daily longitudinal self-reporting of chronic pain. Digit Health 2023; 9:20552076231194544. [PMID: 37599898 PMCID: PMC10434844 DOI: 10.1177/20552076231194544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/27/2023] [Indexed: 08/22/2023] Open
Abstract
Background As management of chronic pain continues to be suboptimal, there is a need for tools that support frequent, longitudinal pain self-reporting to improve our understanding of pain. This study aimed to assess the feasibility and acceptability of daily pain self-reporting using a smartphone-based pain manikin. Methods For this prospective feasibility study, we recruited adults with lived experience of painful musculoskeletal condition. They were asked to complete daily pain self-reports via an app for 30 days. We assessed feasibility by calculating pain report completion levels, and investigated differences in completion levels between subgroups. We assessed acceptability via an end-of-study questionnaire, which we analysed descriptively. Results Of the 104 participants, the majority were female (n = 87; 84%), aged 45-64 (n = 59; 57%), and of white ethnic background (n = 89; 86%). The mean completion levels was 21 (± 7.7) pain self-reports. People who were not working (odds ratio (OR) = 1.84; 95% confidence interval (CI), 1.52-2.23) were more likely, and people living in less deprived areas (OR = 0.77; 95% CI, 0.62-0.97) and of non-white ethnicity (OR = 0.45; 95% CI, 0.36-0.57) were less likely to complete pain self-reports than their employed, more deprived and white counterparts, respectively. Of the 96 participants completing the end-of-study questionnaire, almost all participants agreed that it was easy to complete a pain drawing (n = 89; 93%). Conclusion It is feasible and acceptable to self-report pain using a smartphone-based manikin over a month. For its wider adoption for pain self-reporting, the feasibility and acceptability should be further explored among people with diverse socio-economic and ethnic backgrounds.
Collapse
Affiliation(s)
- Syed Mustafa Ali
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - David A Selby
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- German Research Center for Artificial Intelligence (DFKI), Kaiserslautern, Germany
| | - Darryl Bourke
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Ramiro D Bravo Santisteban
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Health Sciences, Faculty of Science, VU University, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Jill Firth
- Integrated Care Centre, Pennine MSK Partnership, Oldham, UK
| | | | - Ben Parker
- Kellgren Centre for Rheumatology, NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - William G Dixon
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester NHS Foundation Trust, Manchester, UK
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| |
Collapse
|
22
|
Didyk C, Lewis LK, Lange B. Availability, content and quality of commercially available smartphone applications for the self-management of low back pain: a systematic assessment. Disabil Rehabil 2022; 44:7600-7609. [PMID: 34612133 DOI: 10.1080/09638288.2021.1979664] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Explore smartphone apps that may be recommended by clinicians for the self-management of low back pain. METHODS Prospectively registered systematic assessment of self-contained apps for self-management of low back pain on the Google Play and Apple App stores (Oceania), including ≥1 NICE low back pain and sciatica clinical guideline-recommended component and functioning without health professional input. Outcomes were quality (Mobile App Rating Scale; MARS), and self-management (Self-Management Support Checklist; SMS-14) and behaviour change potential (App Behaviour Change Scale; ABACUS). RESULTS 25 apps were included. The average quality of included apps was acceptable (Mean MARS score of 3.9 out of a maximum possible 5). The self-management support and behaviour change potential of included apps appeared low (mean SMS-14 score was 3.4/14; mean ABACUS score was 5.4/21). The apps showed no significant correlation between app consumer ratings and MARS scores. App quality was significantly correlated with app price (p = 0.049) but not consumer ratings, however, these findings were based on a small number of studies and the overall model was not significant. CONCLUSIONS Smartphone apps for the self-management of low back pain are of average to good quality, with questionable potential for self-management and behaviour change. Clinicians should consider that few apps were designed to specifically incorporate self-management support and behaviour change potential when recommending apps to clients. Further development in these areas of app design would be of benefit.Implications for RehabilitationSmartphone apps have the potential to improve LBP self-management outcomes, however, apps are not well regulated and the quality of information and advice provided is often low quality.The findings from this systematic assessment indicate that LBP self-management apps have limited self-management support and behaviour change potential features.Recommendation of current smartphone apps for LBP should take into consideration that although apps are of acceptable quality they are not specifically designed with self-management support and behaviour change principles.App quality does not appear to be associated with consumer ratings, however, there may be a positive association between app price and quality which requires further investigation.
Collapse
Affiliation(s)
- Claudia Didyk
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Lucy Kate Lewis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| |
Collapse
|
23
|
Tajudeen FP, Bahar N, Tan MP, Peer Mustafa MB, Saedon NI, Jesudass J. Understanding User Requirements for a Senior-Friendly Mobile Health Application. Geriatrics (Basel) 2022; 7:geriatrics7050110. [PMID: 36286212 PMCID: PMC9602267 DOI: 10.3390/geriatrics7050110] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/09/2022] Open
Abstract
The advancement of mobile technologies has motivated countries around the world to aim for smarter health management to support senior citizens. However, the use of mobile health applications (mHealth apps) among senior citizens appears to be low. Thus, drawing upon user expectations, the present study examined user requirements for a senior-friendly mHealth application. A total of 74 senior citizens were interviewed to explore the difficulties they encounter when using existing mobile apps. This study followed Nielsen’s usability model to identify user requirements from five aspects, namely learnability, efficiency, memorability, error, and satisfaction. Based on the results, a guideline was proposed pertaining to usability and health management features. This guideline offers suggestions for mHealth app issues related to phrasing, menus, simplicity, error messages, icons and buttons, navigation, and layout, among others. The study also found that speech recognition technology can help seniors access information quickly. The proposed guideline and findings offer valuable input for software and app developers in building more engaging and senior-friendly mHealth apps.
Collapse
Affiliation(s)
- Farzana Parveen Tajudeen
- Department of Management, Faculty of Business and Economics, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence:
| | - Nurhidayah Bahar
- Center for Software Technology and Management, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Mumtaz Begum Peer Mustafa
- Department of Software Engineering, Faculty of Computer Science & Information Technology, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nor Izzati Saedon
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Jenifer Jesudass
- Department of Management, Faculty of Business and Economics, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
24
|
Báez Gutiérrez N, Rodríguez Ramallo H, Fernández González M, Abdel-Kader Martín L. Smartphone Apps for Patients With Hematologic Malignancies: Systematic Review and Evaluation of Content. JMIR Mhealth Uhealth 2022; 10:e35851. [PMID: 36125860 PMCID: PMC9533204 DOI: 10.2196/35851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/21/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hematological malignancies (HMs) are a heterogeneous group of cancers representing a significant cause of morbidity and mortality. The chronification of HMs and the increasing use of smartphones may lead patients to seek their current unmet needs through mobile health apps. OBJECTIVE The goal of this review was to identify and assess the quality of smartphone apps aimed at patients diagnosed with HMs. METHODS A systematic search of apps that were aimed at patients diagnosed with HMs, accessed from a Spain IP address, and were available on the iOS (App Store) and Android (Google Play) platforms was conducted in November 2021. The search terms used were "hematology," "blood cancer," "leukemia," "lymphoma," and "myeloma" apps in English, Spanish, or both languages. The identified apps were downloaded and analyzed independently by 2 reviewers. Information about general app characteristics was collected. The Mobile Application Rating Scale (MARS) was used to assess quality. The resulting parameter of the analyses, the mean score of the apps, was compared by Student t test. RESULTS Overall, 18 apps were identified; 7 were available on Android, 5 were available on iOS, and 6 were available on both platforms. All included apps were free; 3 were published in 2021, and among the apps published before 2021, only 6 were updated in 2021. Most (16/18, 89%) of the apps were aimed at patients with leukemia or lymphoma (16). The primary purposes of the apps were to provide general information about the condition (16/18, 89%) and monitor symptoms and clinical parameters (11/18, 61%). Health care professionals contributed to the development of 50% (9/18) of apps; 6 were owned and supported by scientific societies, and 3 were developed with the participation of health care professionals. The mean MARS score for the overall quality of the apps was 3.1 (SD 1.0). The engagement and aesthetics subscales were the lowest rated subscales, with only 44% (8/18) and 67% (12/18), respectively, of the apps obtaining acceptable scores. None of the included apps proved clinical efficacy through clinical trials in patients with HMs. Statistically significant differences were found in the MARS scores between operating systems (+1.0, P=.003) in favor of iOS apps. The participation of health care professionals in the development of the apps did not have a statistically significant impact on the MARS scores. CONCLUSIONS This systematic search and evaluation identified few acceptable quality mobile apps for patients with HMs. Current and future apps for patients with HMs should provide evidence-based valuable information, improve user engagement, incorporate functions according to patient preferences, and generate evidence regarding the efficacy of app use by patients with HMs.
Collapse
|
25
|
MacPherson M, Bakker AM, Anderson K, Holtzman S. Do pain management apps use evidence-based psychological components? A systematic review of app content and quality. Can J Pain 2022; 6:33-44. [PMID: 35694141 PMCID: PMC9176230 DOI: 10.1080/24740527.2022.2030212] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background With hundreds of pain management apps on the Canadian marketplace, it can be challenging for patients and clinicians to select effective and evidence-based mobile health (mHealth) apps that address pain from a biopsychosocial perspective. Aims The aim of this study is to identify pain management apps within the Canadian app marketplaces to aid clinicians in recommending apps. Methods The iOS and Android marketplaces were systematically searched to identify pain management apps that included at least one core component of cognitive behavioral therapy (CBT) or mindfulness- and acceptance-based therapies. Selected apps were assessed using a researcher developed psychological components checklist, and the Mobile App Rating Scale (MARS). These two measures provided a robust assessment of the apps' technical abilities and psychological principles being implemented. Results Five hundred eight pain management apps were identified, yet only 12 included a psychological component and were available for evaluation. On average, apps contained 8.10 out of 18 psychological components (SD = 2.77) with a MARS quality rating of 4.02 out of 5 (SD = 0.32). The most common psychological components were grounded in CBT, including psychoeducation, sleep hygiene, behavioral activation, coping skills training, and social support. Among the least commonly included components were goal setting, values, and culture/diversity. Two-thirds of the apps involved health care practitioners in their development, but independent scientific review of apps was scarce. Conclusion The highest scoring apps (Curable, Pathways, Vivify) are highlighted for health care practitioners who may wish to recommend mHealth technologies to their patients for pain management. Future directions for research and app development are discussed.
Collapse
Affiliation(s)
- Megan MacPherson
- School of Health and Exercise Sciences, University of British Columbia,Okanagan Campus; 3333 University Way, Kelowna, BC, V1V 1V, Canada,CONTACT Megan MacPherson School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; 3333 University Way, Kelowna, BC, V1V 1V7, Canada
| | - A. Myfanwy Bakker
- Department of Psychology, Universiy of British Columbia, Kelowna, British Columbia, Canada
| | - Koby Anderson
- Department of Psychology, Universiy of British Columbia, Kelowna, British Columbia, Canada
| | - Susan Holtzman
- Department of Psychology, Universiy of British Columbia, Kelowna, British Columbia, Canada
| |
Collapse
|
26
|
Turesson C, Liedberg G, Vixner L, Lofgren M, Björk M. Evidence-based digital support during 1 year after an Interdisciplinary Pain Rehabilitation Programme for persons with chronic musculoskeletal pain to facilitate a sustainable return to work: a study protocol for a registry-based multicentre randomised controlled trial. BMJ Open 2022; 12:e060452. [PMID: 35470201 PMCID: PMC9039404 DOI: 10.1136/bmjopen-2021-060452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Chronic musculoskeletal pain (CMSP) severely affects the individual's quality of life, functioning and ability to work, and comes with significant societal costs for sick leave and productivity loss. After rehabilitation, patients with CMSP often experience lack of support when responsibility for the return-to-work process is taken over by the employer. Therefore, we aim to evaluate the effectiveness of a digital support (Sustainable WorkEr digital support for Persons with chronic Pain and their Employers (SWEPPE)) for promoting a sustainable return-to-work for persons with CMSP and to facilitate the employers' supportive role and responsibilities in the process. METHODS AND ANALYSIS In this registry-based multicentre randomised controlled trial, 360 patients with CMSP will be randomised to either receive the smartphone application SWEPPE (n=180) or to a control group (n=180). The intervention group will use SWEPPE for 1 year and the control group will not receive any intervention for return to work (RTW). Participants will be recruited from approximately 10 specialist and primary care level units connected to the Swedish National Quality Registry for Pain Rehabilitation providing Interdisciplinary Pain Rehabilitation Programmes (IPRP) for CMSP. Eligibility criteria are age 18-65 years and a need for support in RTW or continued support at work for creating a sustainable work situation. Baseline data will be collected when the participants have completed the IPRP. Final assessment will be performed after 12 months. The primary outcome will be a number of days with sickness cash benefit. Secondary outcomes and explanatory variables including important domains affected by CMSP such as health-related quality of life, functioning and work ability will be collected. ETHICS AND DISSEMINATION The Swedish Ethics Review Board approved the study (Dnr 2020-01593, Dnr 2021-01854). The study findings will be disseminated through publication, national and international conferences, and meetings to be available for patients, healthcare providers or stakeholders. TRIAL REGISTRATION NUMBER NCT05058547.
Collapse
Affiliation(s)
- Christina Turesson
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Gunilla Liedberg
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Linda Vixner
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Monika Lofgren
- Department of Clinical Sciences and Department of Rehabilitation Medicine Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mathilda Björk
- Department of Health Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| |
Collapse
|
27
|
Mande A, Moore SL, Banaei-Kashani F, Echalier B, Bull S, Rosenberg MA. Assessment of a Mobile Health iPhone App for Semiautomated Self-management of Chronic Recurrent Medical Conditions Using an N-of-1 Trial Framework: Feasibility Pilot Study. JMIR Form Res 2022; 6:e34827. [PMID: 35412460 PMCID: PMC9044158 DOI: 10.2196/34827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/11/2022] [Accepted: 02/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Management of chronic recurrent medical conditions (CRMCs), such as migraine headaches, chronic pain, and anxiety/depression, remains a major challenge for modern providers. Our team has developed an edge-based, semiautomated mobile health (mHealth) technology called iMTracker that employs the N-of-1 trial approach to allow self-management of CRMCs. OBJECTIVE This study examines the patterns of adoption, identifies CRMCs that users selected for self-application, and explores barriers to use of the iMTracker app. METHODS This is a feasibility pilot study with internet-based recruitment that ran from May 15, 2019, to December 23, 2020. We recruited 180 patients to pilot test the iMTracker app for user-selected CRMCs for a 3-month period. Patients were administered surveys before and after the study. RESULTS We found reasonable usage rates: a total of 73/103 (70.9%) patients who were not lost to follow-up reported the full 3-month use of the app. Most users chose to use the iMTracker app to self-manage chronic pain (other than headaches; 80/212, 37.7%), followed by headaches in 36/212 (17.0%) and mental health (anxiety and depression) in 27/212 (12.8%). The recurrence rate of CRMCs was at least weekly in over 93% (169/180) of patients, with 36.1% (65/180) of CRMCs recurring multiple times in a day, 41.7% (75/180) daily, and 16.1% (29/180) weekly. We found that the main barriers to use were the design and technical function of the app, but that use of the app resulted in an improvement in confidence in the efficiency and safety/privacy of this approach. CONCLUSIONS The iMTracker app provides a feasible platform for the N-of-1 trial approach to self-management of CRMCs, although internet-based recruitment provided limited follow-up, suggesting that in-person evaluation may be needed. The rate of CRMC recurrence was high enough to allow the N-of-1 trial assessment for most traits.
Collapse
Affiliation(s)
- Archana Mande
- Division of Personalized Medicine and Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Susan L Moore
- mHealth Impact Laboratory, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Farnoush Banaei-Kashani
- College of Engineering and Applied Science, University of Colorado Denver, Denver, CO, United States
| | - Benjamin Echalier
- Clinical Research Support Team, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Sheana Bull
- mHealth Impact Laboratory, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Michael A Rosenberg
- Division of Personalized Medicine and Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| |
Collapse
|
28
|
Turesson C, Liedberg G, Björk M. Development of a Digital Support Application With Evidence-Based Content for Sustainable Return to Work for Persons With Chronic Pain and Their Employers: User-Centered Agile Design Approach. JMIR Hum Factors 2022; 9:e33571. [PMID: 35285814 PMCID: PMC8961348 DOI: 10.2196/33571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Persons with chronic pain experience a lack of support after completing rehabilitation and the responsibility for the return-to-work (RTW) process is taken over by the employer. In addition, employers describe not knowing how to support their employees. Smartphone apps have been increasingly used for self-management, but there is a lack of available eHealth apps with evidence-based content providing digital support for persons with chronic pain and their employers when they return to work. OBJECTIVE This study aims to describe the development of a digital support application with evidence-based content that includes a biopsychosocial perspective on chronic pain for sustainable RTW for persons with chronic pain and their employers (SWEPPE [Sustainable Worker Digital Support for Persons With Chronic Pain and Their Employers]). METHODS A user-centered agile design approach was applied. The multidisciplinary project team consisted of health care researchers, a user representative, and a software team. A total of 2 reference groups of 7 persons with chronic pain and 4 employers participated in the development process and usability testing. Mixed methods were used for data collection. The design was revised using feedback from the reference groups. The content of SWEPPE was developed based on existing evidence and input from the reference groups. RESULTS The reference groups identified the following as important characteristics to include in SWEPPE: keeping users motivated, tracking health status and work situation, and following progress. SWEPPE was developed as a smartphone app for the persons with chronic pain and as a web application for their employers. SWEPPE consists of six modules: the action plan, daily self-rating, self-monitoring graphs, the coach, the library, and shared information with the employer. The employers found the following functions in SWEPPE to be the most useful: employees' goals related to RTW, barriers to RTW, support wanted from the employer, and the ability to follow employees' progress. The persons with chronic pain found the following functions in SWEPPE to be the most useful: setting a goal related to RTW, identifying barriers and strategies, and self-monitoring. Usability testing revealed that SWEPPE was safe, useful (ie, provided relevant information), logical, and easy to use with an appealing interface. CONCLUSIONS This study reports the development of a digital support application for persons with chronic pain and their employers. SWEPPE fulfilled the need of support after an interdisciplinary pain rehabilitation program with useful functions such as setting a goal related to RTW, identification of barriers and strategies for RTW, self-monitoring, and sharing information between the employee and the employer. The user-centered agile design approach contributed to creating SWEPPE as a relevant and easy-to-use eHealth intervention. Further studies are needed to examine the effectiveness of SWEPPE in a clinical setting.
Collapse
Affiliation(s)
- Christina Turesson
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Gunilla Liedberg
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
29
|
Perry MA, Devan H, Davies C, Hempel D, Ingham T, Jones B, Reid S, Saipe B, Hale L. iSelf-Help: a co-designed, culturally appropriate, online pain management programme in Aotearoa. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:6. [PMID: 35193704 PMCID: PMC8862515 DOI: 10.1186/s40900-022-00339-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Current best practice recommends group-based pain management programmes for long-term improvements in persistent pain-related disability. However, there are barriers for people to access in-person delivered pain management programmes in Aotearoa. AIMS To develop a co-designed, culturally responsive, online group-based pain management programme (iSelf-help) for people with persistent pain. METHODS A modified participatory action research (PAR) framework was used to co-design contents and cultural-appropriateness of iSelf-help. The PAR team included: (1) seven end-users living with persistent pain, who had previously attended an in-person delivered group pain management programme, (2) two pain management clinicians, (3) two health researchers, (4) two digital health experts, and (5) a health literacy expert. Five meetings were held with the PAR group and a Nominal Group Technique was used to rank order the preferred features of content delivery. In parallel, to ensure cultural appropriateness of iSelf-help, three focus groups (n = 15) were held with Māori (the Indigenous population of Aotearoa) living with persistent pain in collaboration with a Māori community health trust. All contents were reviewed by a Māori Health literacy expert and core contents were translated into Te Reo (Māori language). All contents were finalised by iterative discussion among the PAR team and consultation with Māori stakeholders. The preliminary version of iSelf-help was pilot tested with the PAR group participants and Māori community members living with persistent pain and their feedback was included. The iterative co-design process occurred over a period of nine months. RESULTS The finalised version of iSelf-help included a total of 130 resources organised in to 12 content relevant online modules plus a dedicated welcoming page and an online community forum. Each module included: short videos, animations explaining main concepts, patient stories, written content to accompany visual content, podcasts of relaxation techniques, illustrated texts, and evidence-summaries. A dedicated module of videos demonstrating cardiovascular and strengthening exercises of varying intensity was also included. CONCLUSIONS This is the first co-created, culturally appropriate, on-line group pain management programme for people with persistent pain, developed in Aotearoa. The next step is to evaluate the clinical and cost-effectiveness of iSelf-help compared to in-person delivered pain management programme.
Collapse
Affiliation(s)
- Meredith A Perry
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, Aotearoa, New Zealand.
| | - Hemakumar Devan
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, Aotearoa, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma and Research Trust, Wellington, New Zealand
| | - Dagmar Hempel
- Wellington Pain Management Service, Capital & Coast District Health Board, Wellington, New Zealand
| | - Tristram Ingham
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Bernadette Jones
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Susan Reid
- Health Literacy New Zealand, Auckland, New Zealand
| | - Barbara Saipe
- Wellington Pain Management Service, Capital & Coast District Health Board, Wellington, New Zealand
| | - Leigh Hale
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
30
|
Li Y, Wang Z, You W, Liu X. Core self-evaluation, mental health and mobile phone dependence in Chinese high school students: why should we care. Ital J Pediatr 2022; 48:28. [PMID: 35164819 PMCID: PMC8842945 DOI: 10.1186/s13052-022-01217-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Mobile phone dependence is a common problem in the population of high school students. We aimed to evaluate the core self-evaluation, mental health and mobile phone dependence in Chinese high school students, to provide reliable evidence to the support of high school students. Methods We conducted a survey of high school students in Xiamen, China. The self-assessment questionnaire on mobile phone use dependence among teenagers (SQAPMPU), Mental Health Scale for Middle School Students (MSSMHS) and Core self-evaluation scale were used to evaluate the mobile phone dependence, mental health and core self-evaluation. t-tests, Pearson correlation and multiple linear stepwise regression analyses were conducted to analyze the potential relationships. Results A total of 1692 students were enrolled. The total score of mobile phone dependence of students in grades 10–12 was higher than that of students in grades 7–9. A total of 329 students in grades 7–9 and 371 students in grades 10–12 had abnormal mental status. The detection rate of psychological abnormalities among students in grades 10–12 was higher than that of students in grades 10–12. Core self-evaluation had significantly negative correlation with various factors of mental health (P < 0.01). The worse the mental health, the higher the degree of mobile phone dependence, core self-evaluation played a mediating role between mental health and mobile phone dependence (8.03%). Conclusions Core self-evaluation is an important factor affecting the mental health of high school students and mobile phone dependence. Educators should strengthen core self-evaluation of high school students to improve the mental health and reduce the mobile phone dependence.
Collapse
|
31
|
Kelly M, Fullen B, Martin D, McMahon S, McVeigh JG. eHealth Interventions to Support Self-Management in People With Musculoskeletal Disorders, "eHealth: It's TIME"-A Scoping Review. Phys Ther 2022; 102:6506314. [PMID: 35079826 PMCID: PMC8994513 DOI: 10.1093/ptj/pzab307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE eHealth-mediated interventions have been proposed as one option to support self-management in those with musculoskeletal disorders (MSDs). This scoping review aimed to chart the evidence regarding eHealth modalities, musculoskeletal diagnosis, and outcomes of eHealth-mediated self-management support interventions in persons with MSDs and identify any gaps within the literature. METHODS Six electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Database of Systematic Reviews), 7 grey literature sources (eg, OpenGrey), and reference and citation lists of included studies were searched from database inception to July 2020. Published studies of adult participants with a MSD utilizing an eHealth intervention to support self-management were included. Studies were limited to those published in English. Two reviewers independently screened all studies. Data were extracted by 1 reviewer and reviewed by another reviewer. RESULTS After screening 3377 titles and abstracts followed by 176 full texts, 87 studies fulfilled the eligibility criteria. The majority were published in the last 5 years (n = 48; 55%), with almost one-third originating in the United States (n = 28; 32%). The most common eHealth modality type was internet based (n = 22; 35%), with almost one-half (n = 41; 47%) of the included studies involving participants with widespread musculoskeletal symptoms. The most commonly reported outcomes were related to body functions (ie, pain intensity) (n = 67; 45%), closely followed by activities and participation (ie, function) (n = 65; 44%), with environmental factors (ie, health care utilization) the least commonly reported (n = 17; 20%). CONCLUSIONS There is considerable variation within the eHealth-mediated self-management support intervention literature. Research is needed on the role of eHealth-mediated self-management support interventions across a broad range of MSDs to guide clinical practice. IMPACT This scoping review has identified gaps in the literature relating to specific eHealth modalities, musculoskeletal diagnoses, and health care utilization data, which should guide future research.
Collapse
Affiliation(s)
- Marie Kelly
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland,Department of Physiotherapy, Mercy University Hospital, Cork, Ireland,Address all correspondence to Marie Kelly at:
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom,NIHR Applied Research Collaborative, North East and North Cumbria, United Kingdom
| | - Sinéad McMahon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
32
|
Pach D, Blödt S, Wang J, Keller T, Bergmann B, Rogge AA, Barth J, Icke K, Roll S, Witt CM. App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e31482. [PMID: 34994708 PMCID: PMC8783271 DOI: 10.2196/31482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/11/2021] [Accepted: 11/12/2021] [Indexed: 12/05/2022] Open
Abstract
Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490
Collapse
Affiliation(s)
- Daniel Pach
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Susanne Blödt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jiani Wang
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theresa Keller
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Beatrice Bergmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alizé A Rogge
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia M Witt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| |
Collapse
|
33
|
O'Connor SR, Kee F, Thompson DR, Cupples ME, Donnelly M, Heron N. A review of the quality and content of mobile apps to support lifestyle modifications following a transient ischaemic attack or 'minor' stroke. Digit Health 2021; 7:20552076211065271. [PMID: 34950500 PMCID: PMC8689637 DOI: 10.1177/20552076211065271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/19/2021] [Indexed: 12/27/2022] Open
Abstract
Objective Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to evaluate the quality of apps for supporting lifestyle change following a TIA or ‘minor’ stroke. Methods Systematic searches of Google Play and the Apple Store were carried out to identify mobile apps released between 1 November 2019 and 1 October 2021. Keywords were used including stroke, TIA, lifestyle, prevention and recovery. Quality was assessed using the Mobile Application Rating Scale (MARS). Common components were identified with the Behaviour Change Technique (BCT) Taxonomy. Descriptive statistics were used to summarize the performance results for each app. Results Searches identified 2545 potential apps. Thirty remained after removing duplicates and screening titles and descriptions. Six were eligible after full review of their content. All apps included at least one BCT (range: 1–16 BCTs). The most frequent BCTs included ‘information about health consequences’ (n = 5/6), ‘verbal or visual communication from a credible source’ (n = 4/6) and ‘action planning’ (n = 4/6). The mean MARS score was 2.57/5 (SD: 0.51; range: 1.78–3.36). No apps were of ‘good’ overall quality (scoring more than 4/5). Conclusions This is the first review of mobile health interventions for this population. Only a small number of apps were available. None were targeted specifically at people with a TIA or ‘minor’ stroke. Overall quality was low. Further work is needed to develop and test accessible, user designed, and evidence-informed digital interventions in this population.
Collapse
Affiliation(s)
- Seán R O'Connor
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Neil Heron
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| |
Collapse
|
34
|
Merolli M, Francis JJ, Vallance P, Bennell KL, Malliaras P, Hinman RS. Patient-Facing Mobile Apps to Support Physiotherapy Care: Protocol for a Systematic Review of Apps Within App Stores. JMIR Res Protoc 2021; 10:e29047. [PMID: 34889767 PMCID: PMC8704116 DOI: 10.2196/29047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 09/29/2021] [Accepted: 10/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background Care delivered by physiotherapists aims to facilitate engagement in positive health behaviors by patients (eg, adherence to exercise). However, research suggests that behavioral interventions are frequently omitted from care. Hence, better understanding of strategies that can be used by physiotherapists to support patients to engage in positive behaviors is important and likely to optimize outcomes. Digital health interventions delivered via mobile apps are garnering attention for their ability to support behavior change. They have potential to incorporate numerous behavior change techniques (BCTs) to support goals of physiotherapy care, including but not limited to self-monitoring, goal setting, and prompts/alerts. Despite their potential to support physiotherapy care, much is still unknown about what apps are available to consumers, the BCTs they use, their quality, and their potential to change behaviors. Objective The primary aim of this study is to systematically review the mobile apps available in app stores that are intended for use by patients to support physiotherapy care, including the BCTs within these apps. The secondary aims are to evaluate the quality and behavior change potential of these apps. Methods A systematic review of mobile apps in app stores will be undertaken. This will be guided by recommendations for systematic reviews in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement but adapted to suit our app store search, consistent with similar systematic reviews of apps published in the Journal of Medical Internet Research. Apple Store and Google Play will be searched with a two-step search strategy, using terms relevant to physiotherapy, physiotherapists, and common physiotherapy care. Key eligibility criteria will include apps that are intended for use by patients and are self-contained or stand-alone without the need of additional wearable devices or other add-ons. Included apps will be coded for BCTs and rated for quality using the Mobile Application Rating Scale (MARS) and for potential to change behavior using the App Behavior Change Scale (ABACUS). Results App store search and screening are expected to be completed in 2021. Data extraction and quality appraisal are expected to commence by November 2021. The study results are expected to be published in a subsequent paper in 2022. Conclusions Knowledge gained from this review will support clinical practice and inform research by providing a greater understanding of the quality of currently available mobile apps and their potential to support patient behavior change goals of physiotherapy care. International Registered Report Identifier (IRRID) PRR1-10.2196/29047
Collapse
Affiliation(s)
- Mark Merolli
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Australia
| | - Jill J Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Patrick Vallance
- School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Peter Malliaras
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
35
|
Areli E, Godfrey HK, Perry MA, Hempel D, Saipe B, Grainger R, Hale L, Devan H. 'I think there is nothing . . . that is really comprehensive': healthcare professionals' views on recommending online resources for pain self-management. Br J Pain 2021; 15:429-440. [PMID: 34840791 DOI: 10.1177/2049463720978264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives To explore healthcare professionals' views on, and attitudes, towards recommending online resources for persistent pain self-management. Methods This study was the qualitative phase of a two-phase mixed method study. Thirty-one New Zealand health professionals involved in the management of persistent pain were interviewed via focus groups and individual interviews. Data were analysed using the general inductive approach. Results The major themes were as follows: (1) risks and limits of online information outweigh benefits, (2) a blended model, of online resources with healthcare professional support, could work, (3) only trustworthy resources can be recommended, (4) need for personalisation and (5) perceived barriers to adoption. Conclusion Online resources were perceived as a useful adjunct to support pain self-management; however, due to potential risks of misinterpretation and misinformation, healthcare professionals proposed a 'blended model' where curated online resources introduced during face-to-face consultations could be used to support self-management. Participants needed 'trustworthy online resources' that provide evidence-based, updated information that is personalised to clients' health literacy and cultural beliefs. Practice implications Training for healthcare professionals on critical appraisal of online resources or curation of evidence-based online resources could increase recommendation of online resources to support pain self-management as an adjunct to in-person care.
Collapse
Affiliation(s)
- E Areli
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - H K Godfrey
- Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand.,Centre for Science in Society, Victoria University of Wellington, Wellington, New Zealand
| | - M A Perry
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand
| | - D Hempel
- Pain Management Service, Capital and Coast District Health Board, Wellington, New Zealand
| | - B Saipe
- Pain Management Service, Capital and Coast District Health Board, Wellington, New Zealand
| | - R Grainger
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - L Hale
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Dunedin, New Zealand
| | - H Devan
- School of Physiotherapy, Centre for Health, Activity and Rehabilitation Research (CHARR), University of Otago, Wellington, New Zealand
| |
Collapse
|
36
|
The Association of Mobile Health Applications with Self-Management Behaviors among Adults with Chronic Conditions in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910351. [PMID: 34639651 PMCID: PMC8507726 DOI: 10.3390/ijerph181910351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Abstract
Background: Mobile applications related to health and wellness (mHealth apps) are widely used to self-manage chronic conditions. However, research on whether mHealth apps facilitate self-management behaviors of individuals with chronic conditions is sparse. We aimed to evaluate the association of mHealth apps with different types of self-management behaviors among patients with chronic diseases in the United States. Methods: This is a cross-sectional observational study. We used data from adult participants (unweighted n = 2340) of the Health Information National Trends Survey in 2018 and 2019. We identified three self-management behaviors: (1) resource utilization using electronic personal health records; (2) treatment discussions with healthcare providers; and (3) making healthcare decisions. We analyzed the association of mHealth apps to self-management behaviors with multivariable logistic and ordinal regressions. Results: Overall, 59.8% of adults (unweighted number = 1327) used mHealth apps. Adults using mHealth apps were more likely to use personal health records (AOR = 3.11, 95% CI 2.26–4.28), contact healthcare providers using technology (AOR = 2.70, 95% CI 1.93–3.78), and make decisions on chronic disease management (AOR = 2.59, 95% CI 1.93–3.49). The mHealth apps were associated with higher levels of self-management involvement (AOR = 3.53, 95% CI 2.63–4.72). Conclusion: Among individuals with chronic conditions, having mHealth apps was associated with positive self-management behaviors.
Collapse
|
37
|
Kongsted A, Jensen TS, Doktor K, Hestbæk L. Effects of weekly pain monitoring on back pain outcomes: a non-randomised controlled study. Chiropr Man Therap 2021; 29:37. [PMID: 34530882 PMCID: PMC8444569 DOI: 10.1186/s12998-021-00393-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disease monitoring is an important element of self-management of several chronic diseases. Pain monitoring has become very easily available, but the role in musculoskeletal pain conditions is not clear. Awareness of pain might be helpful for people to understand pain, but focusing on pain may on the contrary negatively affect pain experience and behaviours. The objective of this study was to investigate the potential impact of pain monitoring on low back pain (LBP), specifically to determine if pain intensity, activity limitation and pain control, differed between patients with weekly pain monitoring over 12 months and patients with follow-ups at 2 weeks, 3 months and 12 months. METHODS This was a non-randomised controlled study embedded in a cohort study with data collection November 1st 2016 to December 21st 2018. Adults seeking care for LBP were enrolled at the first visit to a chiropractor and followed with surveys after 2 weeks, 3 months and 12 months. Those enrolled first, n = 1,623, furthermore received weekly SMS-questions about pain frequency and pain intensity, whereas those enrolled next was the control group, n = 1,269 followed only by surveys. Outcomes at 12-months were compared, adjusting for group differences on baseline parameters. RESULTS LBP intensity (0-10) was slightly lower at 12-months follow-up in the SMS group than the control group (adjusted beta - 0.40 (95% CI: - 0.62; - 0.19)). No relevant between-group differences were observed for activity limitation (0-100) (1.51 (95% CI: - 0.83; 3.85)) or ability to control pain (0-10) (- 0.08 (95% CI - 0.31; 0.15)). CONCLUSIONS Frequent pain monitoring did not demonstrate any negative effects of weekly pain monitoring, and it was perhaps even helpful. The role of self-monitoring as part of self-managing LBP should be explored further including optimal frequencies, formats, and methods for feedback. TRIAL REGISTRATION The study was not registered as a clinical trial.
Collapse
Affiliation(s)
- Alice Kongsted
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark. .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Tue Secher Jensen
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Diagnostic Center, Silkeborg Regional Hospital, Falkevej 1, 8600, Silkeborg, Denmark
| | - Klaus Doktor
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Lise Hestbæk
- Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Diagnostic Center, Silkeborg Regional Hospital, Falkevej 1, 8600, Silkeborg, Denmark
| |
Collapse
|
38
|
Ledermann K, Abou Khaled O, Caon M, Berger T, Chabwine JN, Wicht J, Martin-Soelch C. An Ecological Monitoring and Management App (EMMA) for Older Adults With Chronic Pain: Protocol for a Design and Feasibility Study. JMIR Res Protoc 2021; 10:e26930. [PMID: 34435969 PMCID: PMC8430865 DOI: 10.2196/26930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Chronic pain is a complex problem for many older adults that affects both physical functioning and psychological well-being. Mobile health (mHealth) technologies have shown promise in supporting older persons in managing chronic conditions. Cognitive behavior therapy is recommended for older people with chronic pain. However, web-based treatment programs for chronic pain are not aimed at the needs of older people and offer standard therapies without providing tailored treatment for this population. Objective To address this problem, we aim to develop a psychological web-based intervention for ecological monitoring of daily life experiences with chronic pain called EMMA to support self-management of chronic pain in older adults. Methods The key clinical and engagement features of the intervention were established through the integration of evidence-based material from cognitive behavioral therapy for the treatment of chronic pain in older adults. The development process uses a co-design approach and actively involves end-users in the design process by incorporating feedback from focus groups with older adults in order to inform a user-centered intervention design. For the co-design process, we will include 10 older adults with chronic pain, who will discuss the requirements for the app in workshops in order to ensure suitability of the app for older adults with chronic pain. In order to test the feasibility and acceptability of the intervention, we will include a sample of 30 older adults with chronic pain who will test all features of the intervention for a period of 8 consecutive weeks. After the trial period, validated instruments will be used to assess usability and acceptability, as well as influence on pain levels and associated physical and psychological symptoms. Participants will be invited to take part in a semistructured telephone interviews after the trial period to explore their experiences using the app. Results Digitalization of the pain diary and psychotherapeutic content has started. Recruitment of participants for the co-design workshops will start as soon as we have a functioning prototype of the electronic pain diary and EMMA intervention, which is expected to be in September 2021. The feasibility study will start as soon as the co-design process is finished and required changes have been implemented into the pain diary and the EMMA intervention. We expect to start the feasibility study early in 2022. Conclusions Required changes to assure usability and acceptability will be directly implemented in the app. EMMA brings together a strong body of evidence using cognitive behavioral and self-management theory with contemporary mHealth principles, allowing for a cost-effective intervention that can be used to target chronic pain anywhere and anytime by older adults. Given the ubiquity of mHealth interventions for chronic conditions, the results of this study may serve to inform the development of tailored self-management interventions. International Registered Report Identifier (IRRID) PRR1-10.2196/26930
Collapse
Affiliation(s)
- Katharina Ledermann
- Department of Consiliar and Liaison Psychiary, University Hospital Zurich, Zurich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Omar Abou Khaled
- Human Tech Institute, School of Engineering, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Maurizio Caon
- Digital Business Center, School of Management, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Berne, Berne, Switzerland
| | - Joelle N Chabwine
- Division of Neurorehabilitation, Fribourg Hospital, Fribourg, Switzerland.,Neurology Unit, Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Joachim Wicht
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | | |
Collapse
|
39
|
Kelly M, Fullen B, Martin D, McMahon S, McVeigh JG. eHealth interventions to support self-management in people with musculoskeletal disorders: a scoping review protocol. JBI Evid Synth 2021; 19:709-720. [PMID: 33725715 DOI: 10.11124/jbies-20-00147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this scoping review is to explore existing literature related to the role of eHealth interventions in supporting self-management in those with musculoskeletal disorders in order to investigate and chart the evidence, and identify any gaps within the literature. INTRODUCTION Musculoskeletal disorders are one of the leading causes of disability worldwide. Self-management interventions are consistently recommended as a core component of treatment for people with musculoskeletal disorders. Given limited health care resources, there is increasing interest in the potential role of eHealth interventions to support self-management in this population. INCLUSION CRITERIA Studies that include adult participants (older than 18 years) with a musculoskeletal disorder will be considered. Studies that include participants with pain of specific pathological origin (eg, infection, malignancy, osteoporosis, inflammatory disease, fracture), those who are pregnant, or individuals following surgery will be excluded. The concept is eHealth interventions that support self-management conducted in any setting and geographical location. All settings and locations will be included. METHODS The following electronic databases will be searched with no limit on publication date: MEDLINE, CINAHL, PsycINFO, Embase, Scopus and the Cochrane Database of Systematic Reviews. A structured search of the gray literature will also be conducted. Studies will be limited to those published in English. Two reviewers will undertake title and abstract screening, followed by full-text screening. Data extraction will be conducted utilizing a standardized form for included studies, and a narrative summary will accompany the charted results and will describe how the results relate to the review's objective. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (https://osf.io/29rd6).
Collapse
Affiliation(s)
- Marie Kelly
- Department of Physiotherapy, Mercy University Hospital, Cork, Ireland.,Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Sinéad McMahon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
40
|
Magee MR, McNeilage AG, Avery N, Glare P, Ashton-James CE. mHealth Interventions to Support Prescription Opioid Tapering in Patients With Chronic Pain: Qualitative Study of Patients' Perspectives. JMIR Form Res 2021; 5:e25969. [PMID: 34003133 PMCID: PMC8170552 DOI: 10.2196/25969] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with chronic pain who are tapering prescription opioids report a need for greater support for coping with symptoms of pain and withdrawal. Mobile health (mHealth) technologies (SMS text messaging- or app-based) have the potential to provide patients with educational, emotional, and motivational support for opioid tapering beyond what is offered by their health care provider. However, it is not known whether patients with chronic pain who are tapering opioids would be willing or able to engage with technology-based support. OBJECTIVE This study aims to examine patients' use of mobile technologies in health care, interest in using mHealth support, preferences for the form and content of mHealth support, and potential barriers to and facilitators of engagement with mHealth support for opioid tapering. METHODS A total of 21 patients (11 women and 10 men; age range 29-83 years) with chronic noncancer pain on long-term opioid therapy who had recently initiated a voluntary opioid taper were recruited from primary and tertiary care clinics in metropolitan and regional Australia for a larger study of patients' experiences of opioid tapering. Participants had been taking prescription opioids for a mean duration of 13 (SD 9.6; range 0.25-30) years at the time of the study. Survey items characterized participants' typical mobile phone use and level of interest in mobile technology-based support for opioid tapering. Semistructured interviews further explored patients' use of mobile technologies and their interest in, preferences for, and perspectives on potential barriers to and facilitators of engagement with mHealth support for opioid tapering. Two researchers collaborated to conduct a thematic analysis of the interview data. RESULTS All participants reported owning and using a mobile phone, and most (17/21, 81%) participants reported using mobile apps. The majority of participants expressed interest in SMS text messaging-based (17/21, 81%) and app-based (15/21, 71%) support for opioid tapering. Participants expected that messages delivering both informational and socioemotional support would be helpful. Participants expected that access to technology, mobile reception, internet connectivity, vision impairment, and low self-efficacy for using apps may be barriers to user engagement. Patients expected that continuity of care from their health care provider, flexible message dosing, responsivity, and familiarity with pain self-management strategies would increase user engagement. CONCLUSIONS The results of this study indicate that patients with chronic noncancer pain may be willing to engage with SMS text messaging-based and app-based mHealth interventions to support opioid tapering. However, the feasibility and acceptability of these interventions may depend on how patients' preferences for functionality, content, and design are addressed.
Collapse
Affiliation(s)
- Michael Reece Magee
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia
| | - Amy Gray McNeilage
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia
| | - Nicholas Avery
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia
| | - Paul Glare
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia
| | - Claire Elizabeth Ashton-James
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia
| |
Collapse
|
41
|
Lopes F, Rodrigues M, Silva AG. User-Centered Development of a Mobile App for Biopsychosocial Pain Assessment in Adults: Usability, Reliability, and Validity Study. JMIR Mhealth Uhealth 2021; 9:e25316. [PMID: 33988515 PMCID: PMC8164126 DOI: 10.2196/25316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/21/2020] [Accepted: 03/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background Pain-related mobile apps targeting pain assessment commonly limit pain assessment to pain behaviors and physiological aspects. However, current guidelines state that pain assessment should follow the biopsychosocial model, clearly addressing biological, psychological, and social aspects of the pain experience. Existing reviews also highlight that pain specialists and end users are not commonly involved in the development process of mobile apps for pain assessment, negatively affecting the quality of the available apps. Objective This study aimed to develop a mobile app for pain assessment (AvaliaDor) and assess its usability, validity, reliability, and measurement error in a sample of real patients with chronic pain recruited from a physiotherapy clinic. Methods This study was divided into 2 phases: phase 1—development of the AvaliaDor app; and phase 2—assessment of the apps’ usability, reliability, measurement error, and validity. AvaliaDor was developed (phase 1) based on the literature and the recommendations of physiotherapists and patients with pain in cycles of evaluation, inclusion of recommendations, and reevaluation until no further changes were required. The final version of the app was then tested in patients with musculoskeletal pain attending a private physiotherapy practice (phase 2) who were asked to use the app twice on 2 consecutive days for reliability purposes. In addition, participants had to complete a set of paper-based scales (Brief Pain Inventory, painDETECT, Pain Catastrophizing Scale, and Tampa Scale for Kinesiophobia), which were used to assess the validity (criterion validity and hypothesis testing) of the app, and the Post-Study System Usability Questionnaire was used to assess its usability. Results The development process (phase 1) included 5 physiotherapists external to the research team and 5 patients with musculoskeletal pain, and it resulted in the creation of an app named AvaliaDor, which includes an assessment of pain intensity, location, and phenotype; associated disability; and the issues of pain catastrophizing and fear of movement. A total of 52 patients with pain (mean age 50.12 years, SD 11.71 years; 39 females) participated in phase 2 and used the app twice. The Pearson correlation coefficient between the scores on the paper-based scales and the app ranged between 0.81 and 0.93 for criterion validity and between 0.41 and 0.59 for hypothesis testing. Test-retest reliability was moderate to good (intraclass correlation coefficient between 0.67 and 0.90) and the score for usability was 1.16 (SD 0.27), indicating good usability. Conclusions A mobile app named AvaliaDor was developed to assess the intensity, location, and phenotype of pain; associated disability; and the issues of pain catastrophizing and fear of movement in a user-centered design process. The app was shown to be usable, valid, and reliable for assessing pain from a biopsychosocial perspective in a heterogeneous group of patients with pain. Future work can explore the long-term use of AvaliaDor in clinical contexts and its advantages for the assessment and management of patients with pain.
Collapse
Affiliation(s)
- Filipa Lopes
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Mário Rodrigues
- Higher School of Technology and Management of Águeda, Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Aveiro, Portugal
| | - Anabela G Silva
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| |
Collapse
|
42
|
Gladman T, Tylee G, Gallagher S, Mair J, Grainger R. Measuring the Quality of Clinical Skills Mobile Apps for Student Learning: Systematic Search, Analysis, and Comparison of Two Measurement Scales. JMIR Mhealth Uhealth 2021; 9:e25377. [PMID: 33890859 PMCID: PMC8105752 DOI: 10.2196/25377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/01/2021] [Accepted: 03/18/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Mobile apps are widely used in health professions, which increases the need for simple methods to determine the quality of apps. In particular, teachers need the ability to curate high-quality mobile apps for student learning. OBJECTIVE This study aims to systematically search for and evaluate the quality of clinical skills mobile apps as learning tools. The quality of apps meeting the specified criteria was evaluated using two measures-the widely used Mobile App Rating Scale (MARS), which measures general app quality, and the Mobile App Rubric for Learning (MARuL), a recently developed instrument that measures the value of apps for student learning-to assess whether MARuL is more effective than MARS in identifying high-quality apps for learning. METHODS Two mobile app stores were systematically searched using clinical skills terms commonly found in medical education and apps meeting the criteria identified using an approach based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9 apps were identified during the screening process. The apps were rated independently by 2 reviewers using MARS and MARuL. RESULTS The intraclass correlation coefficients (ICCs) for the 2 raters using MARS and MARuL were the same (MARS ICC [two-way]=0.68; P<.001 and MARuL ICC [two-way]=0.68; P<.001). Of the 9 apps, Geeky Medics-OSCE revision (MARS Android=3.74; MARS iOS=3.68; MARuL Android=75; and MARuL iOS=73) and OSCE PASS: Medical Revision (MARS Android=3.79; MARS iOS=3.71; MARuL Android=69; and MARuL iOS=73) scored highly on both measures of app quality and for both Android and iOS. Both measures also showed agreement for the lowest rated app, Patient Education Institute (MARS Android=2.21; MARS iOS=2.11; MARuL Android=18; and MARuL iOS=21.5), which had the lowest scores in all categories except information (MARS) and professional (MARuL) in both operating systems. MARS and MARuL were both able to differentiate between the highest and lowest quality apps; however, MARuL was better able to differentiate apps based on teaching and learning quality. CONCLUSIONS This systematic search and rating of clinical skills apps for learning found that the quality of apps was highly variable. However, 2 apps-Geeky Medics-OSCE revision and OSCE PASS: Medical Revision-rated highly for both versions and with both quality measures. MARS and MARuL showed similar abilities to differentiate the quality of the 9 apps. However, MARuL's incorporation of teaching and learning elements as part of a multidimensional measure of quality may make it more appropriate for use with apps focused on teaching and learning, whereas MARS's more general rating of quality may be more appropriate for health apps targeting a general health audience. Ratings of the 9 apps by both measures also highlighted the variable quality of clinical skills mobile apps for learning.
Collapse
Affiliation(s)
- Tehmina Gladman
- Education Unit, University of Otago Wellington, Wellington, New Zealand
| | - Grace Tylee
- Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Steve Gallagher
- Education Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jonathan Mair
- Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Rebecca Grainger
- Education Unit, University of Otago Wellington, Wellington, New Zealand
| |
Collapse
|
43
|
Ali SM, Lau WJ, McBeth J, Dixon WG, van der Veer SN. Digital manikins to self-report pain on a smartphone: A systematic review of mobile apps. Eur J Pain 2021; 25:327-338. [PMID: 33113241 PMCID: PMC7839759 DOI: 10.1002/ejp.1688] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Chronic pain is the leading cause of disability. Improving our understanding of pain occurrence and treatment effectiveness requires robust methods to measure pain at scale. Smartphone-based pain manikins are human-shaped figures to self-report location-specific aspects of pain on people's personal mobile devices. METHODS We searched the main app stores to explore the current state of smartphone-based pain manikins and to formulate recommendations to guide their development in the future. RESULTS The search yielded 3,938 apps. Twenty-eight incorporated a pain manikin and were included in the analysis. For all apps, it was unclear whether they had been tested and had end-user involvement in the development. Pain intensity and quality could be recorded in 28 and 13 apps, respectively, but this was location specific in only 11 and 4. Most manikins had two or more views (n = 21) and enabled users to shade or select body areas to record pain location (n = 17). Seven apps allowed personalising the manikin appearance. Twelve apps calculated at least one metric to summarise manikin reports quantitatively. Twenty-two apps had an archive of historical manikin reports; only eight offered feedback summarising manikin reports over time. CONCLUSIONS Several publically available apps incorporated a manikin for pain reporting, but only few enabled recording of location-specific pain aspects, calculating manikin-derived quantitative scores, or generating summary feedback. For smartphone-based manikins to become adopted more widely, future developments should harness manikins' digital nature and include robust validation studies. Involving end users in the development may increase manikins' acceptability as a tool to self-report pain. SIGNIFICANCE This review identified and characterised 28 smartphone apps that included a pain manikin (i.e. pain drawings) as a novel approach to measure pain in large populations. Only few enabled recording of location-specific pain aspects, calculating quantitative scores based on manikin reports, or generating manikin feedback. For smartphone-based manikins to become adopted more widely, future studies should harness the digital nature of manikins, and establish the measurement properties of manikins. Furthermore, we believe that involving end users in the development process will increase acceptability of manikins as a tool for self-reporting pain.
Collapse
Affiliation(s)
- Syed Mustafa Ali
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Wei J. Lau
- Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
| | - John McBeth
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - William G. Dixon
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Sabine N. van der Veer
- Centre for Epidemiology Versus ArthritisUniversity of ManchesterManchesterUK
- Centre for Health InformaticsDivision of Informatics, Imaging and Data SciencesUniversity of ManchesterManchesterUK
- NIHR Manchester Musculoskeletal Biomedical Research CentreCentral Manchester University Hospitals NHS Foundation TrustManchesterUK
- Manchester Academic Health Science Centre (MAHSC)University of ManchesterManchesterUK
| |
Collapse
|
44
|
Kawi J, Yeh CH, Li M, Caswell, BS K, Mazraani, MD M, Lukkahatai, PhD, RN N, Mensah, RN S, Taylor J, Budhathoki C, Christo P. Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial. Glob Adv Health Med 2021; 10:2164956120987531. [PMID: 33623727 PMCID: PMC7876936 DOI: 10.1177/2164956120987531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/14/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal pain (CMP) is the most common self-reported chronic pain condition. Current treatment for CMP is limited. METHODS This was a two-phase study. In Phase 1, three auricular point acupressure (APA)-naïve participants were recruited to explore their experiences of APA and a smartphone app was developed based on their feedback. In Phase 2, a prospective longitudinal study was used to examine the effectiveness of the smartphone app to self-manage CMP. RESULTS Phase 1 resulted in the successful development of the APA smartphone app. In Phase 2, after four weeks of APA, participants reported reduced pain intensity (30%), pain interference (35%), and disability (40%), as well as improved physical function (47%). The mean score for the participants' perception of treatment efficacy was 4.94 (SD = 2.08, scale of 0-7) indicating that approximately 70% of participants rated global improvements with noticeable changes. The majority (88%, n = 22) of the participants were satisfied with the treatment: 32% [8] were very satisfied and 56% [n = 14] were somewhat satisfied. The average frequency of pressing APA seeds per day was 2.93 times (SD = 2.27, range 0-10) and 1.60 minutes per time (SD = 2.64, range 0-10); the participants were able to adhere to the suggested pressing time per day, although they only pressed the ear points about 53% of the suggested time. CONCLUSION It is feasible for individuals to learn APA from the smartphone app and successfully self-administer APA to manage their pain. Participants found the app useful and were satisfied with the information provided through the app.
Collapse
Affiliation(s)
- Jennifer Kawi
- School of Nursing, University of Nevada, Las Vegas, Las Vegas,
Nevada
| | - Chao Hsing Yeh
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Mengchi Li
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Keenan Caswell, BS
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | | | | | - Sylvanus Mensah, RN
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Janiece Taylor
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University School of Nursing,
Baltimore, Maryland
| | - Paul Christo
- School of Medicine, Johns Hopkins University School of Medicine,
Baltimore, Maryland
| |
Collapse
|
45
|
Dresler T, Guth AL, Lüpke J, Kropp P. [Psychological treatment of headache in times of COVID-19]. Schmerz 2020; 34:503-510. [PMID: 33030591 PMCID: PMC7543037 DOI: 10.1007/s00482-020-00507-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has substantially changed life worldwide in 2020. This also influences the psychological treatment options of patients with headache. AIM The present article intends to illustrate the different psychological forms of treatment for headache patients and their implementation during the COVID-19 pandemic. MATERIAL AND METHODS Literature review and case reports. RESULTS Even during the COVID-19 pandemic, psychological treatment enables the increased stress level in headache patients to be counteracted by using cognitive behavioral therapy and relaxation techniques. The changed living conditions are often unfavorable but sometimes also favorable in the course of disease. It can be shown that even during the pandemic, such favorable changes can be used to support patients to cope with their headache. CONCLUSION The digital implementation of psychological approaches makes a major contribution to maintaining psychological treatment of headache patients, so that the individually changed needs can be addressed. With respect to content, stress regulation techniques and increased acceptance gain in importance. Regarding biofeedback there are limitations, which may be overcome by improved technical devices.
Collapse
Affiliation(s)
- T Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Deutschland.
| | - A-L Guth
- Migräne- und Kopfschmerzklinik Königstein, Königstein, Deutschland
| | - J Lüpke
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - P Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
| |
Collapse
|
46
|
Richardson PA, Harrison LE, Heathcote LC, Rush G, Shear D, Lalloo C, Hood K, Wicksell RK, Stinson J, Simons LE. mHealth for pediatric chronic pain: state of the art and future directions. Expert Rev Neurother 2020; 20:1177-1187. [PMID: 32881587 PMCID: PMC7657989 DOI: 10.1080/14737175.2020.1819792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Chronic pain conditions are common among children and engender cascading effects across social, emotional, and behavioral domains for the child and family. Mobile health (mHealth) describes the practice of delivering healthcare via mobile devices and may be an ideal solution to increase access and reach of evidence-based behavioral health interventions. AREAS COVERED The aim of this narrative review is to present a state-of-the-art overview of evidence-based mHealth efforts within the field of pediatric chronic pain and consider new and promising directions for study. Given the nascent nature of the field, published mHealth interventions in all stages of development are discussed. Literature was identified through a non-systematic search in PubMed and Google Scholar, and a review of reference lists of papers that were identified as particularly relevant or foundational (within and outside of the chronic pain literature). EXPERT OPINION mHealth is a promising interventional modality with early evidence suggesting it is primed to enhance behavioral health delivery and patient outcomes. There are many exciting future directions to be explored including drawing inspiration from digital health technology to generate new ways of thinking about the optimal treatment of pediatric chronic pain.
Collapse
Affiliation(s)
- Patricia A. Richardson
- Departments of Pediatric Psychology and Pediatric Pain and Palliative Medicine, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Lauren E. Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lauren C. Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Gillian Rush
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Deborah Shear
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Chitra Lalloo
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada
| | - Korey Hood
- Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Stinson
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg, Faculty of Nursing, The University of Toronto, Toronto, Canada
| | - Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
47
|
|
48
|
Small C, Laycock H. Are we near to making virtual reality the new reality in pain medicine? Anaesthesia 2020; 76:590-593. [PMID: 32918754 DOI: 10.1111/anae.15252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- C Small
- Department of Anaesthesia and Pain Medicine, County Hospital, Hereford, UK
| | - H Laycock
- Department of Paediatric Anaesthesia and Pain Management, Great Ormond Street Hospital and Honorary Academic Clinical Lecturer, Imperial College, London, UK
| |
Collapse
|
49
|
A systematic review into the assessment of medical apps: motivations, challenges, recommendations and methodological aspect. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00451-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
50
|
Koepp J, Baron MV, Hernandes Martins PR, Brandenburg C, Kira ATF, Trindade VD, Ley Dominguez LM, Carneiro M, Frozza R, Possuelo LG, De Mello Pinto MV, Mahlmann Kipper L, Pinheiro da Costa BE. The Quality of Mobile Apps Used for the Identification of Pressure Ulcers in Adults: Systematic Survey and Review of Apps in App Stores. JMIR Mhealth Uhealth 2020; 8:e14266. [PMID: 32470916 PMCID: PMC7327590 DOI: 10.2196/14266] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background The increasing global use of smartphones has contributed to the growing use of apps for various health conditions, showing promising results. Through mobile apps, it is possible to perform chronological and iconographic follow-up of wounds, such as pressure ulcers, using a simple and practical tool. However, numerous surveys have pointed out issues related to the functionality, design, safety, and veracity of app information. Objective The objective of this study was to perform a systematic review of published studies regarding mobile apps and a systematic survey in app stores looking for apps developed to identify, evaluate, treat, and/or prevent pressure ulcers in adults, and to evaluate those apps based on software quality characteristics. Methods This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The main bibliographic databases were searched between January 1, 2007 and October 15, 2018, and an app survey was performed in app stores. The selected studies were evaluated according to software quality characteristics by the International Organization for Standardization/International Electrotechnical Commission (ie, ISO/IEC 25010:2011) that involve functionality, efficiency, compatibility, usability, reliability, safety, maintenance, and portability. Results The search in databases and web-based app stores returned a total of 2075 studies. After removal of duplicates and screening of titles and abstracts, 48 complete articles were evaluated for eligibility, and among these, six were included for qualitative synthesis. Conclusions In this review, it was observed that all studies involved the initial phase of app development or improvement, and therefore, the apps still need to be evaluated using different software quality characteristics, so that in the future, a gold standard can be approached. Therefore, the prescription of an app for the identification, evaluation, treatment, and/or prevention of pressure ulcers in adults is currently limited. However, the evaluated studies provided important insights for future research. It is of utmost importance that future surveys develop apps jointly with users, using collaborative and cocreative processes and assess patients in real-world situations across different service settings, and they should consider different ethnicities, so that apps are useful to end users, such as patients, family members, health professionals, and students, in the health area. In addition, it is necessary for studies to describe the methodological course of app development in a clear and objective way in order to ensure reproducibility of the study and to offer inputs to allow future research to approach the development of ideal apps that are geared to positively impact the health of end users. Trial Registration PROSPERO CRD42018114137; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=114137
Collapse
Affiliation(s)
- Janine Koepp
- University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil.,Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miriam Viviane Baron
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,Coordination of Improvement of Higher Education Personnel - Brazil, Brasília, Brazil
| | | | - Cristine Brandenburg
- Federal University of Ceará, Fortaleza, Brazil.,National Council for Scientific and Technological Development - Brazil, Brasilia, Brazil
| | | | - Vanessa Devens Trindade
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,National Council for Scientific and Technological Development - Brazil, Brasilia, Brazil
| | | | | | - Rejane Frozza
- University of Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | | | | | | | | |
Collapse
|