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Cited by 115Mobile Health and mHealth ApplicationsMusculoskeletal pain and rehabilitationDigital Mental Health Interventions

Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review

Open access
Devan, Hemakumar, Farmery, Devin, Peebles, Lucy, Grainger, Rebecca·2019·JMIR mHealth and uHealth
DOI 10.2196/13080PMC PMC6390192

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Abstract

BACKGROUND: Smartphone apps are a potential mechanism for development of self-management skills in people with persistent pain. However, the inclusion of best-practice content items in available pain management apps fostering core self-management skills for self-management support is not known. OBJECTIVE: The aim of the study was to evaluate the contents of smartphone apps providing information on pain management strategies for people with persistent pain facilitating self-management support and to appraise the app quality. METHODS: A systematic search was performed in the New Zealand App Store and Google Play Store. Apps were included if they were designed for people with persistent pain, provided information on pain self-management strategies, and were available in English. App contents were evaluated using an a priori 14-item self-management support (SMS-14) checklist. App quality was assessed using the 23-item Mobile Apps Rating Scale. RESULTS: Of the 939 apps screened, 19 apps met the inclusion criteria. Meditation and guided relaxation were the most frequently included self-management strategies. Overall, the included apps met a median of 4 (range 1-8) of the SMS-14 checklist. A total of 3 apps (Curable, PainScale-Pain Diary and Coach, and SuperBetter) met the largest number of items (8 out of 14) to foster self-management of pain. Self-monitoring of symptoms (n=11) and self-tailoring of strategies (n=9) were frequently featured functions, whereas a few apps had features facilitating social support and enabling communicating with clinicians. No apps provided information tailored to the cultural needs of the user. The app quality mean scores using Mobile Apps Rating Scale ranged from 2.7 to 4.5 (out of 5.0). Although use of 2 apps (Headspace and SuperBetter) has been shown to improve health outcomes, none of the included apps have been evaluated in people with persistent pain. CONCLUSIONS: Of the 3 apps (Curable, PainScale-Pain Diary and Coach, and SuperBetter) that met the largest number of items to support skills in self-management of pain, 2 apps (PainScale-Pain Diary and Coach and SuperBetter) were free, suggesting the potential for using apps as a scalable, wide-reaching intervention to complement face-to-face care. However, none provided culturally tailored information. Although 2 apps (Headspace and SuperBetter) were validated to show improved health outcomes, none were tested in people with persistent pain. Both users and clinicians should be aware of such limitations and make informed choices in using or recommending apps as a self-management tool. For better integration of apps in clinical practice, concerted efforts are required among app developers, clinicians, and people with persistent pain in developing apps and evaluating for clinical efficacy.

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  • Most existing digital pain management programs focus on providing information about pain and collecting and monitoring data and often lack a theoretical basis.

    “Most such programs appear to focus on providing information about pain and collecting and monitoring data (eg, tracking medication use) and often lack a theoretical basis, such as evidence-based psychosocial interventional aspects [21,22].”

    From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [22]

    The Introduction (Background; page unavailable) describes pain apps that provide information and track symptoms, including medications, and the Results (App Characteristics and Content; page unavailable) find self-monitoring in 11 of 19 reviewed apps. But the review says pain education was seldom included and meditation and relaxation were the most common strategies. It does not establish that the apps generally lacked a theoretical basis. (LLM, conf=0.84)

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  • There is limited evidence of actual implementation of digital pain self-management interventions into clinical care after study completion.

    “with subsequent limited evidence of actual implementation into clinical care after study completion [22,28].”

    From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [22]

    The Discussion’s Principal Findings say that none of the 19 reviewed apps had been evaluated in people with pain and that features for communicating with clinicians were infrequent. Those findings do not address whether digital pain self-management interventions were implemented in clinical care after studies ended; searches for post-study implementation and clinical uptake found no passage that does. (LLM, conf=0.72)

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Research works printed but not linked: 1

  1. [54]Devan H Perry M Shipton E Dowell A Jones B Ingham T Gray A Leung W Hoermann S Hempel D Saipe B Grainger R Hale L Health Informatics New Zealand (HiNZ) Conference 2017 2018-12-10 Co-creating a self-management eHealth resource by the people and for the people with persistent pain https://cdn.ymaws.com/hinz.site-ym.com/resource/resmgr/conference_2017/HiNZ17_proceedings.pdf

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Authors
Devan, H., Farmery, D., Peebles, L., & Grainger, R.
Affiliations
University of Otago (NZ)
Corresponding author
Devan, Hemakumar
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2019-02-12
Volume
7
Issue
2
Pages
e13080
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/13080
PMC
PMC6390192
OpenAlex
W2909711840
Cited by
115
References
60
Citations by year
2026: 4 · 2025: 22 · 2024: 24 · 2023: 14 · 2022: 17 · 2021: 14 · 2020: 17 · 2019: 3
FWCI
2.34
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
chronic pain, pain self-management, mobile application, self-management support, app quality, symptom self-monitoring, culturally tailored interventions, mobile health, headspace, social support, provider communication, app store search
MeSH terms
Self-Management, Adult, Female, Humans, Male, Middle Aged, New Zealand, Chronic Pain, Pain Management, Mobile Applications

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