Leveraging mobile health technology and research methodology to optimize patient education and self-management support for advanced cancer pain

Azizoddin, Desiree R.; Adam, Rosalind; Kessler, Daniela; Wright, Alexi A.; Kematick, Benjamin; Sullivan, Clare; Zhang, Haipeng; Hassett, Michael J.; Cooley, Mary E.; Ehrlich, Olga; Enzinger, Andrea C.

doi:10.1007/s00520-021-06146-4

Cited by 18 publications

(14 citation statements)

References 37 publications

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“…Indeed, the development of mHealth solutions requires a diverse set of expertise, including software programmers, behavioral scientists, graphical designers, and medical experts, such as doctors and physiotherapists. It also requires end-user feedback about the solutions so that the vendors can match actual users’ real-life needs [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Contrasting the Expectations and Experiences Related to Mobile Health Use for Chronic Pain: Questionnaire Study

Kheirinejad¹,

Alorwu²,

Visuri³

et al. 2022

JMIR Hum Factors

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Background Chronic pain is a prolonged condition that deteriorates one's quality of life. Treating chronic pain requires a multicomponent approach, and in many cases, there are no “silver bullet” solutions. Mobile health (mHealth) is a rapidly expanding category of solutions in digital health with proven potential in chronic pain management. Objective This study aims to contrast the viewpoints of 2 groups of people with chronic pain concerning mHealth: people who have adopted the use of mHealth and those who have not. We highlight the benefits of mHealth solutions for people with chronic pain and the perceived obstacles to their increased adoption. We also provide recommendations to encourage people to try mHealth solutions as part of their self-care. Methods The Prolific crowdsourcing platform was used to collect crowdsourced data. A prescreening questionnaire was released to determine what type of pain potential participants have and whether they are currently using mHealth solutions for chronic pain. The participants were invited based on their experience using mHealth to manage their pain. Similar questions were presented to mHealth users and nonusers. Qualitative and quantitative analyses were performed to determine the outcomes of this study. Results In total, 31 responses were collected from people (aged 19-63 years, mean 31.4, SD 12.1) with chronic pain who use mHealth solutions. Two-thirds (n=20, 65%) of the users identified as female and 11 (35%) as male. We matched these mHealth users with an equal number of nonusers: 31 responses from the pool of 361 participants in the prescreening questionnaire. The nonusers’ ages ranged from 18 to 58 years (mean 30.8, SD 11.09), with 15 (50%) identifying as female and 15 (50%) as male. Likert-scale questions were analyzed using the Mann-Whitney-Wilcoxon (MWW) test. Results showed that the 2 groups differed significantly on 10 (43%) of 23 questions and shared similar views in the remaining 13 (57%). The most significant differences were related to privacy and interactions with health professionals. Of the 31 mHealth users, 12 (39%) declared that using mHealth solutions has made interacting with health or social care professionals easier (vs n=22, 71%, of nonusers). The majority of the nonusers (n=26, 84%) compared with about half of the users (n=15, 48%) expressed concern about sharing their data with, for example, third parties. Conclusions This study investigated how mHealth is currently used in the context of chronic pain and what expectations mHealth nonusers have for mHealth as a future chronic pain management tool. Analysis revealed contrasts between mHealth use expectations and actual usage experiences, highlighting privacy concerns toward mHealth solutions. Generally, the results showed that nonusers are more concerned about data privacy and expect mHealth to facilitate interacting with health professionals. The users, in contrast, feel that such connections do not exist.

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Section: Introductionmentioning

confidence: 99%

Contrasting the Expectations and Experiences Related to Mobile Health Use for Chronic Pain: Questionnaire Study

Kheirinejad¹,

Alorwu²,

Visuri³

et al. 2022

JMIR Hum Factors

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“…mHealth interventions have also shown potential to reach a large population due to ease of access, resulting in economic benefits to patients and healthcare systems [56]. In people with advanced cancer, improvements in cancer-related pain were observed after mHealth enabled psychoeducation that would otherwise only be accessible when implemented by a specialist [57]. Technology aside, the research emphasizes the requirement for self-management strategies in people with advanced cancer to be individualized and multi-faceted to consider older age, depression, impaired physical functioning, and low literacy, which may lead to greater difficulty in symptom self-management [17].…”

Section: Discussionmentioning

confidence: 99%

Non-Pharmacological Self-Management Strategies for Chemotherapy-Induced Peripheral Neuropathy in People with Advanced Cancer: A Systematic Review and Meta-Analysis

et al. 2022

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Non-pharmacological self-management interventions for chemotherapy-induced peripheral neurotherapy (CIPN) are of clinical interest; however, no systematic review has synthesized the evidence for their use in people with advanced cancer. Five databases were searched from inception to February 2022 for randomized controlled trials assessing the effect of non-pharmacological self-management interventions in people with advanced cancer on the incidence and severity of CIPN symptoms and related outcomes compared to any control condition. Data were pooled with meta-analysis. Quality of evidence was appraised using the Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), with data synthesized narratively. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was applied to assess the certainty of the evidence. Thirteen studies were included, which had a high (69%) or unclear (31%) risk of bias. Greatest confidence was found for physical exercise decreasing CIPN severity (SMD: −0.89, 95% CI: −1.37 to −0.41; p = 0.0003; I2 = 0%; n = 2 studies, n = 76 participants; GRADE level: moderate) and increasing physical function (SMD: 0.51, 95% CI: 0.02 to 1.00; p = 0.04; I2 = 42%; n = 3 studies, n = 120; GRADE level: moderate). One study per intervention provided preliminary evidence for the positive effects of glutamine supplementation, an Omega-3 PUFA-enriched drink, and education for symptom self-management via a mobile phone game on CIPN symptoms and related outcomes (GRADE: very low). No serious adverse events were reported. The strongest evidence with the most certainty was found for physical exercise as a safe and viable adjuvant to chemotherapy treatment for the prevention and management of CIPN and related physical function in people with advanced cancer. However, the confidence in the evidence to inform conclusions was mostly very low to moderate. Future well-powered and appropriately designed interventions for clinical trials using validated outcome measures and clearly defined populations and strategies are warranted.

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“… 22–24 Extension of these technologies to cancer pain is a logical next-step to improve patient care and clinical management. 25 A patient-facing smartphone application has been developed with the aim to provide a comprehensive cancer pain education spanning pharmacologic and behavioral aspects of self-management, with the help of custom graphics, animated videos, quizzes, and audio-recorded 26 . A preliminary testing demonstrated that a digital intervention called “Can-Pain” could promote patient-centred pain management highlighting unrecognised problems, promoting shared understanding about symptoms between patients, caregiver and healthcare professional and supporting shared decision-making.…”

Section: Discussionmentioning

confidence: 99%

What to Do and What Not to Do in the Management of Cancer Pain: A Physician Survey and Expert Recommendations

Bossi

Antonuzzo

Armento

et al. 2021

CMAR

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Background Despite the prevalence of pain among patients with cancer and the availability of pertinent guidelines, the clinical management of oncological pain is decisively insufficient. To address this issue, we evaluated current trends in clinical practice and subsequently generated a list of ten corrective actions—five things to do and five things not to do—for the diagnosis, management, and monitoring of cancer pain. Methods The survey included 18 questions about clinical practice surrounding background pain and breakthrough cancer pain (BTcP). Survey questions were developed by a scientific board of 10 physician experts and communicated via email to an expanded panel of physicians in Italy. Responses were tabulated descriptively for analysis. Results Of 51 invited physicians, 32 (63%) provided complete survey responses. The responses revealed several incongruencies with current guideline recommendations: physicians did not always diagnose or monitor pain using diagnostically validated or disease-specific instruments; frequently based clinical decision-making on time availability or convenience; and pharmacological therapy was often inappropriate (eg, prescribing NSAIDs or corticosteroids for BTcP). The list of corrective actions generated by the scientific board favored a guideline-oriented approach that systematically characterizes oncological pain and implements treatment based on pain characteristics (eg, fast-acting transmucosal opioids for BTcP) and evidence-based recommendations. Conclusion Oncologists require better education and training about the diagnosis, treatment, and monitoring of oncological pain. Physicians should be aware of current guideline recommendations as well as available pharmacological tools for BTcP.

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Leveraging mobile health technology and research methodology to optimize patient education and self-management support for advanced cancer pain

Cited by 18 publications

References 37 publications

Contrasting the Expectations and Experiences Related to Mobile Health Use for Chronic Pain: Questionnaire Study

Contrasting the Expectations and Experiences Related to Mobile Health Use for Chronic Pain: Questionnaire Study

Non-Pharmacological Self-Management Strategies for Chemotherapy-Induced Peripheral Neuropathy in People with Advanced Cancer: A Systematic Review and Meta-Analysis

What to Do and What Not to Do in the Management of Cancer Pain: A Physician Survey and Expert Recommendations

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