Feasibility and Acceptability of a Personalized Assessment of Chronic Abdominal Pain Triggers

Abstract

Background: Though there is general consensus that pediatric chronic abdominal pain is likely the result of interacting biopsychosocial pathways, studies produce mixed evidence for its etiology. These mixed results could be due to the nonstationarity of the effects over time or because there are individual differences uncaptured by current research designs. In either case, intensive longitudinal data collected from the biopsychosocial systems that dynamically influence chronic abdominal pain should add clarity. Objective: The current study aimed to determine if it was feasible and acceptable to use ecological momentary assessment (EMA) to assess biopsychosocial contributors to chronic abdominal pain with two objective sensors and a mobile application. In addition, we aimed to determine if it was possible to identify idiographic pain triggers for each patient. Method: Participants included 30 pediatric chronic abdominal pain patients, aged 8-17, who wore a physiological monitor and accelerometer that measured sleep and physical activity and answered four surveys per day on an app over the course of a 14-day study period. Results: Results indicated that participants were 96.2% and 95.5% compliant to the wrist-worn accelerometer measuring sleep and physical activity, respectively. Participants completed 76.3% of expected surveys and were least adherent to the physiological monitor (37.9%). Additionally, it was possible to generate 24 (80%) personalized reports describing unique pain triggers for participants in the study. Conclusion: Findings support the use of EMA and longitudinal assessment to examine real-time interactions between biopsychosocial variables in this population.2