Benefits of Mobile Apps for Cancer Pain Management: Systematic Review

Abstract

Background Pain ratings reported by patients with cancer continue to increase, and numerous computer and phone apps for managing cancer-related pain have been developed recently; however, whether these apps effectively alleviate patients’ pain remains unknown. Objective This study aimed to comprehensively evaluate the role of mobile apps in the management of cancer pain. Methods Literature on the use of apps for cancer pain management and interventions, published before August 2019, was retrieved from the following databases: MEDLINE, Embase, Cochrane, CINAHL, Scopus, and PsycINFO. The effects of apps on cancer pain were evaluated using RevMan5.3 software, and the rates of adverse drug reactions were analyzed using the R Statistical Software Package 3.5.3. Results A total of 13 studies were selected for the analysis: 5 randomized controlled trials (RCTs), 4 before-after studies, 2 single-arm trials, 1 prospective cohort study, and 1 prospective descriptive study. The 5 RCTs reported data for 487 patients (240 patients in the intervention group and 247 patients in the control group), and the remaining studies reported data for 428 patients. We conducted a meta-analysis of the RCTs. According to the meta-analysis, apps can significantly reduce pain scores (mean difference [MD]=–0.50, 95% CI –0.94 to –0.07, I2=62%, P=.02). We then used apps that have an instant messaging module for subgroup analysis; these apps significantly reduced patients’ pain scores (MD=–0.67, 95% CI –1.06 to –0.28, I2=57%, P<.01). Patients using apps without an instant messaging module did not see a reduction in the pain score (MD=0.30, 95% CI –1.31 to 1.92, I2=70%, P=.71). Overall, patients were highly satisfied with using apps. Other outcomes, such as pain catastrophizing or quality of life, demonstrated greater improvement in patients using apps with instant messaging modules compared with patients not using an app. Conclusions The use of apps with instant messaging modules is associated with reduced pain scores in patients with cancer-related pain, and patient acceptance of these apps is high. Apps without instant messaging modules are associated with relatively higher pain scores. The presence of an instant messaging module may be a key factor affecting the effect of an app on cancer pain.

Checklists for Complications During Systemic Cancer Treatment Shared by Patients, Friends, and Health Care Professionals: Prospective Interventional Cohort Study

“…Only a few studies have reported improvements in quality of life [ 26 , 27 ]. App for monitoring pain and linked to the ability to escalate to a clinician might lead to improved symptom control [ 28 ]. Recruitment rates of 50% in our study are comparable to other trials in this field [ 29 ].…”

A Mobile App to Improve Symptom Control and Information Exchange Among Specialists and Local Health Workers Treating Tanzanian Cancer Patients: Human-Centered Design Approach

“…Specifically, among the randomized controlled studies reviewed, patients who used the tested apps had less pain than patients without access to the apps. Other outcomes, such as quality of life, pain catastrophizing, and pain self-efficacy, were also improved in app users versus in those from control groups [16]. Existing mobile apps used in cancer pain management often offer a range of functions and specifications, including shared records, training, and real-time feedback.…”

“…Existing mobile apps used in cancer pain management often offer a range of functions and specifications, including shared records, training, and real-time feedback. They educate patients about pain and enable documentation of the type of pain experienced as well as feedback regarding symptoms [16]. Importantly, mHealth facilitates pain management among individuals living in rural communities and supports control of other symptoms, including depression [17].…”

“…Limitations to previous studies include small sample sizes and varied follow-up times, including some as short as 14 days. There has been a call for larger samples and longer randomized controlled trials as well as further assessment of app functions most critical to symptom control [16]. Notably, previous studies have included limited involvement of health care providers in the design and development of apps, a limitation likely influencing the utility of these technologies [15,19,20].…”

Leveraging Mobile Health Technology and Multidisciplinary Methodology to Optimize Self-Management Education for Advanced Cancer Pain: Development of STAMP

“…Although some interventions provide opportunities for active learning, few have tailored education or offer longitudinal support that address the dynamic nature of the cancer pain experience [5], [9]- [12]. Moreover, few educational interventions address underlying psychological and behavioral processes that influence pain self-management, such as motivation, stress management, self-efficacy, and addiction fears within the cultural context of the opioid epidemic [3], [4], [9], [10].…”