Development and Testing of an Intelligent Pain Management System (IPMS) on Mobile Phones Through a Randomized Trial Among Chinese Cancer Patients: A New Approach in Cancer Pain Management

Abstract

BackgroundCancer has become increasingly prevalent in China over the past few decades. Among the factors that determine the quality of life of cancer patients, pain has commonly been recognized as a most critical one; it could also lead to the ineffective treatment of the cancer. Driven by the need for better pain management for cancer patients, our research team developed a mobile-based Intelligent Pain Management System (IPMS).ObjectiveOur objective was to design, develop, and test the IPMS to facilitate real-time pain recording and timely intervention among cancer patients with pain. The system’s usability, feasibility, compliance, and satisfaction were also assessed.MethodsA sample of 46 patients with cancer pain symptoms were recruited at the Oncology Center of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch (hereinafter referred to as “the Oncology Center”). In a pretest, participants completed a pain management knowledge questionnaire and were evaluated using the baseline cancer pain assessment and Karnofsky Performance Status (KPS) evaluation. The participants were then randomly assigned into two groups (the trial group and the control group). After a 14-day trial period, another round of cancer pain assessment, KPS evaluation and pain management knowledge assessment were repeated. In the trial group, the data were fully automatically collected by the IPMS. In the control group, the data were collected using conventional methods, such as phone interviews or door-to-door visits by physicians. The participants were also asked to complete a satisfaction questionnaire on the use of the IPMS.ResultsAll participants successfully completed the trial. First, the feasibility of IPMS by observing the number of daily pain assessments recorded among patients was assessed. Second, the users’ satisfaction, effectiveness of pain management, and changes in the quality of their lives were evaluated. All the participants gave high satisfaction score after they used IMPS. Both groups reported similar pain scores and KPS scores at the baseline. At the end of the trial, the mean pain score of the trial group was significantly lower than of the control group (P<.001). The ending KPS score of the trial group was significantly higher than of the control group (P<.001). The improvement of pain management knowledge score in the trial group was more pronounced than that in the control group (P<.001).ConclusionsThis study provided preliminary data to support the potentials of using IPMS in cancer pain communication between patients and doctors and to provide real-time supportive intervention on a convenient basis at a low cost. Overall, the IPMS can serve as a reliable and effective approach to control cancer pain and improve quality of life for patients with cancer pain.Trial RegistrationClinicaltrials.gov NCT02765269; http://clinicaltrials.gov/ct2/show/NCT02765269 (Archived by WebCite at http://www.webcitation.org/6rnwsgDgv)

Benefits of Mobile Apps in Pain Management: Systematic Review

“…Characteristics of included studies are shown in Table 1 and in Multimedia Appendix 2 . A total of 7 RCTs [ 21 - 27 ], 6 before-after studies [ 28 - 33 ], 1 controlled before-after study [ 34 ], and one retrospective data analysis [ 35 ] with a total of 1962 patients were reviewed. Of these, 11 studies were conducted in an out-clinic setting and 4 studies in an in-clinic setting.…”

“…Figure 2 shows improvement in pain over time, and Figure 3 illustrates the effect size of the intervention in 6 controlled studies [ 21 - 23 , 25 , 27 , 34 ]. One study did not provide information about the standard deviation, and therefore, only mean pain values are shown in the graph [ 22 ].…”

“…One study did not provide information about the standard deviation, and therefore, only mean pain values are shown in the graph [ 22 ]. In addition, 4 studies reported a significant improvement in pain in the group using the app [ 21 , 23 , 25 , 27 ]. In another study [ 21 ], patients showed no significant improvement at follow-up after 29 and 58 days.…”

“…All studies evaluating changes in quality of life revealed a statistically significant improvement in the groups using an app [ 23 , 27 , 31 , 32 ]. In addition, 8 studies reported high satisfaction with the ease of use of the app [ 21 , 23 , 25 , 27 - 29 , 33 , 36 ], and 3 studies stated good feasibility of app use with high diary completion rates [ 22 , 27 , 31 ]. Further details about the additional outcomes can be found in Multimedia Appendix 4 .…”

mHealth Supportive Care Intervention for Parents of Children With Acute Lymphoblastic Leukemia: Quasi-Experimental Pre- and Postdesign Study (Preprint)

“…12 Studies have documented the feasibility and effectiveness of mobile apps in supporting adult cancer patients and survivors in healthcare and clinical practice. [13][14][15][16] However, to our knowledge, there has not been much use of apps in supporting parents of pediatric cancer patients.…”