Apps for Older People’s Pain Self-Management: Perspectives of Primary Care and Allied Health Clinicians

Abstract

Background Chronic arthritic pain is one of the major causes of physical suffering and disability among older people. Primary care and allied health clinicians use various approaches to help their older clients better manage their arthritic pain. The growing uptake of technology among older people offers the potential for clinicians to integrate an arthritic pain app into their patients’ self-management plans. This study explored the perspectives of Australian primary care and allied health clinicians regarding the use of pain self-management apps to help their older patients/clients better manage their arthritic pain. Methods Qualitative design using a semistructured interview approach. Interviews were conducted via telephone with primary and allied health clinicians (N = 17) across Australia. Results The overarching theme underlying participants’ views on integration of apps into older people’s pain self-management strategy was that this approach is an idealistic but uniquely challenging endeavor. Four subthemes emerged, namely: 1) self-management apps are a potentially useful tool but require careful consideration; 2) clinicians’ involvement is crucial yet potentially onerous; 3) no single app is right for every older person with arthritic pain; and 4) patient data access is beneficial, but caution is needed for real-time data access. Discussion The predominant clinician perspective of integrating apps into their older patients/clients’ pain self-management strategies was that this approach is an idealistic but uniquely challenging endeavor. Apps were seen as having potential to support various aspects of patients’ self-management behaviors; however, there were notable concerns with regards to the challenges inherent in this approach for both clinicians and older users (patients/clients).

Smartphone Applications Designed to Improve Older People’s Chronic Pain Management: An Integrated Systematic Review

“…The opinions of older people with chronic pain regarding an mHealth intervention via a smartphone suggested the importance of information sharing, including education to support self-care and self-administration of analgesia [ 53 ]. Five of the qualitative studies were pilot or feasibility studies with either service users or health professionals [ 44 , 45 , 47 , 48 , 50 ].…”

“…Older users found it beneficial to have associated input from their clinicians to establish and reinforce the use of technology or a pain self-management app [ 43 , 45 , 46 ]. Clinicians themselves expressed concern that not all service users or the clinicians responsible for their care would be willing to embrace new technology [ 43 , 44 , 48 ]. The importance of clinicians’ engagement with and confidence in the use of the app was presented as important for some of the Australian older people interviewed in Bhattarai’s study of older people using an app for chronic arthritic pain [ 25 , 45 ].…”

“…Bhattarai and colleagues noted the clinician’s perspective on the use of a chatbot app [ 44 ]. The criticality of such a vehicle in facilitating the pain self-management process of older people was acknowledged, particularly because they form a significant and growing proportion of the population requiring access to pain services.…”

“…Data generated from app use could be utilised to improve monitoring and management of older people’s pain through enhanced systems, policies and procedures. In complementary studies, Australian researchers concluded that access to patient data, captured from pain apps, could enhance and improve the monitoring and management of older people’s healthcare needs [ 25 , 36 , 44 , 45 ]. Furthermore, clinicians could benefit from “health systems-level” policies and procedures as informed by the capture and use of such data.…”

Health care providers’ experiences of pain management and attitudes towards digitally supported self-management interventions for chronic pain: a qualitative study

“…A review showed that out of 279 identified pain self-management applications, only 8.2% included health care providers in the development process [ 42 ]. Studies have shown that health care providers are generally positive towards digital health applications for chronic diseases, including chronic pain [ 47 – 50 ]. Despite interest in and positive attitudes towards eHealth solutions, few health care providers recommend the use of applications (apps) or digital solutions to their patients [ 48 , 51 ], and the overall use of eHealth solutions in health care services is limited [ 48 , 49 ].…”