User Engagement and Clinical Impact of the Manage My Pain App in Patients With Chronic Pain: A Real-World, Multi-site Trial

Anuj Bhatia, Jamal Kara, Tahir Janmohamed, Atul Prabhu, Gerald Lebovic, Joel Katz, Hance Clarke, Anuj Bhatia, Jamal Kara, Tahir Janmohamed, Atul Prabhu, Gerald Lebovic, Joel Katz, Hance Clarke

Abstract

Background: Chronic pain imposes a large burden on individuals and society. A patient-centric digital chronic pain management app called Manage My Pain (MMP) can be used to enhance communication between providers and patients and promote self-management.

Objective: The purpose of this study was to evaluate the real-world engagement of patients in urban and rural settings in Ontario, Canada with the MMP app alongside their standard of care and assess the impact of its usage on clinical outcomes of pain and related mental health.

Methods: A total of 246 participants with chronic pain at a rural and 2 urban pain clinics were recruited into this prospective, open-label, exploratory study that compared the use of MMP, a digital health app for pain that incorporates validated questionnaires and provides patients with summarized reports of their progress in combination with standard care (app group), against data entered on paper-based questionnaires (nonapp group). Participants completed validated questionnaires on anxiety, depression, pain catastrophizing, satisfaction, and daily opioid consumption up to 4.5 months after the initial visit (short-term follow-up) and between 4.5 and 7 months after the initial visit (long-term follow-up). Engagement and clinical outcomes were compared between participants in the two groups.

Results: A total of 73.6% (181/246) of the participants agreed to use the app, with 63.4% (111/175) of them using it for at least one month. Individuals who used the app rated lower anxiety (reduction in Generalized Anxiety Disorder 7-item questionnaire score by 2.10 points, 95% CI -3.96 to -0.24) at short-term follow-up and had a greater reduction in pain catastrophizing (reduction in Pain Catastrophizing Scale score by 5.23 points, 95% CI -9.55 to -0.91) at long-term follow-up relative to patients with pain who did not engage with the MMP app.

Conclusions: The use of MMP by patients with chronic pain is associated with engagement and improvements in self-reported anxiety and pain catastrophizing. Further research is required to understand factors that impact continued engagement and clinical outcomes in patients with chronic pain.

Trial registration: ClinicalTrials.gov NCT04762329; https://ichgcp.net/clinical-trials-registry/NCT04762329.

Keywords: app; chronic disease management; chronic pain; digital health; engagement; impact; mHealth; outcome; pain; pain app; pain management; patient-oriented research; psychology; quality of life; remote monitoring; virtual care.

Conflict of interest statement

Conflicts of Interest: TJ is the founder and CEO of ManagingLife Inc, the owner of Manage My Pain. The other authors declare no competing interests or conflicts of interest.

©Anuj Bhatia, Jamal Kara, Tahir Janmohamed, Atul Prabhu, Gerald Lebovic, Joel Katz, Hance Clarke. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 04.03.2021.

Figures

Figure 1
Figure 1
Screenshots of the screens used by Manage My Pain to collect patient-reported outcomes.
Figure 2
Figure 2
Sample clinician-facing report produced by Manage My Pain that contains scored responses to validated measures as well as a summary of the daily tracking.
Figure 3
Figure 3
Flow diagram of group allocation based on participants’ engagement with the app.
Figure 4
Figure 4
Mean values of validated measures in both app (labelled "Intervention – Yes") and nonapp (labelled "Intervention – No") groups at short-term (early) and long-term (late) follow-ups. Error bars indicate the standard error. Means have been centered along the overall mean. GAD-7: Generalized Anxiety Disorder 7-item scale; OME: oral morphine equivalence; PCS: Pain Catastrophizing Scale; PDI: Pain Disability Index; PGIC: Participant Global Impression of Change; PHQ-9: Patient Health Questionnaire 9-item scale.

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