Benefits of Mobile Apps in Pain Management: Systematic Review

Simon E Thurnheer, Isaac Gravestock, Giuseppe Pichierri, Johann Steurer, Jakob M Burgstaller, Simon E Thurnheer, Isaac Gravestock, Giuseppe Pichierri, Johann Steurer, Jakob M Burgstaller

Abstract

Background: Pain is a common condition with a significant physical, psychosocial, and economic impact. Due to enormous progress in mobile device technology as well as the increase in smartphone ownership in the general population, mobile apps can be used to monitor patients with pain and support them in pain management.

Objective: The aim of this review was to assess the efficacy of smartphone or computer tablet apps in the management of patients with pain.

Methods: In December 2017, a literature search was performed in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane, and PsycINFO. In addition, a bibliography search was conducted. We included studies with at least 20 participants per arm that evaluated the effects of apps on smartphones or computer tablets on improvement in pain.

Results: A total of 15 studies with 1962 patients met the inclusion criteria. Of these, 4 studies examined the effect of mobile apps on pain management in an in-clinic setting and 11 in an out-clinic setting. The majority of the original studies reported beneficial effects of the use of a pain app. Severity of pain decreased in most studies where patients were using an app compared with patients not using an app. Other outcomes, such as worst pain or quality of life showed improvements in patients using an app. Due to heterogeneity between the original studies-patient characteristics, app content, and study setting-a synthesis of the results by statistical methods was not performed.

Conclusions: Apps for pain management may be beneficial for patients, particularly in an out-clinic setting. Studies have shown that pain apps are workable and well liked by patients and health care professionals. There is no doubt that in the near future, mobile technologies will develop further. Medicine could profit from this development as indicated by our results, but there is a need for more scientific inputs. It is desirable to know which elements of apps or additional devices and tools may improve usability and help patients in pain management.

Keywords: cell phone; mobile application; pain; pain management; review; smartphone; telemedicine.

Conflict of interest statement

Conflicts of Interest: None declared.

©Simon E Thurnheer, Isaac Gravestock, Giuseppe Pichierri, Johann Steurer, Jakob M Burgstaller. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 22.10.2018.

Figures

Figure 1
Figure 1
Study flow.
Figure 2
Figure 2
Improvement in pain over time in multiple armed studies. Pain scale (Numeric Rating Scale): 0-10.
Figure 3
Figure 3
Forest plot of intervention effect on pain in multiple armed studies. Pain scale (Numeric Rating Scale): 0-10.
Figure 4
Figure 4
Decrease in pain in out-clinic before-after studies and in the retrospective data analysis. Pain scale (Numeric Rating Scale): 0-10.
Figure 5
Figure 5
Decrease in pain in in-clinic before-after studies. Pain scale (Numeric Rating Scale): 0-10.

References

    1. Eurostat. Digital economy and society statistics - households and individuals 2016 .
    1. Eurostat. Mobile connection to internet 2016 .
    1. Eurostat. 2016. Internet use by individuals .
    1. Business Insider. IQVIA Institute for Human Data Science Study: Impact of Digital Health Grows as Innovation, Evidence and Adoption of Mobile Health Apps Accelerate 2017 .
    1. Farzandipour M, Nabovati E, Sharif R, Arani MH, Anvari S. Patient self-management of asthma using mobile health applications: a systematic review of the functionalities and effects. Appl Clin Inform. 2017 Dec;8(4):1068–81. doi: 10.4338/ACI-2017-07-R-0116.
    1. Husted GR, Weis J, Teilmann G, Castensøe-Seidenfaden P. Exploring the influence of a smartphone app (Young with Diabetes) on young people's self-management: qualitative study. JMIR Mhealth Uhealth. 2018 Feb 28;6(2):e43. doi: 10.2196/mhealth.8876.
    1. Ryan EA, Holland J, Stroulia E, Bazelli B, Babwik SA, Li H, Senior P, Greiner R. Improved A1C levels in type 1 diabetes with smartphone app use. Can J Diabetes. 2017 Feb;41(1):33–40. doi: 10.1016/j.jcjd.2016.06.001.
    1. Cui MX, Wu XY, Mao JF, Wang X, Nie M. T2DM self-management via smartphone applications: a systematic review and meta-analysis. PLoS One. 2016;11(11):e0166718. doi: 10.1371/journal.pone.0166718.
    1. Breivik H, Eisenberg E, O'Brien T, OPENMinds The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health. 2013 Dec 24;13:1229. doi: 10.1186/1471-2458-13-1229.
    1. Lalloo C, Jibb LA, Rivera J, Agarwal A, Stinson JN. "There's a Pain App for That": review of patient-targeted smartphone applications for pain management. Clin J Pain. 2015 Jun;31(6):557–63. doi: 10.1097/AJP.0000000000000171.
    1. Lalloo C, Shah U, Birnie KA, Davies-Chalmers C, Rivera J, Stinson J, Campbell F. Commercially available smartphone apps to support postoperative pain self-management: scoping review. JMIR Mhealth Uhealth. 2017 Oct 23;5(10):e162. doi: 10.2196/mhealth.8230.
    1. Rosser BA, Eccleston C. Smartphone applications for pain management. J Telemed Telecare. 2011;17(6):308–12. doi: 10.1258/jtt.2011.101102.
    1. Machado GC, Pinheiro MB, Lee H, Ahmed OH, Hendrick P, Williams C, Kamper SJ. Smartphone apps for the self-management of low back pain: a systematic review. Best Pract Res Clin Rheumatol. 2016 Dec;30(6):1098–1109. doi: 10.1016/j.berh.2017.04.002.
    1. Bhattarai P, Newton-John T, Phillips JL. Quality and usability of arthritic pain self-management apps for older adults: a systematic review. Pain Med. 2018 Mar 01;19(3):471–84. doi: 10.1093/pm/pnx090.
    1. Portelli P, Eldred C. A quality review of smartphone applications for the management of pain. Br J Pain. 2016 Aug;10(3):135–40. doi: 10.1177/2049463716638700.
    1. Wallace LS, Dhingra LK. A systematic review of smartphone applications for chronic pain available for download in the United States. J Opioid Manag. 2014 Feb;10(1):63–8. doi: 10.5055/jom.2014.0193.
    1. Reynoldson C, Stones C, Allsop M, Gardner P, Bennett MI, Closs SJ, Jones R, Knapp P. Assessing the quality and usability of smartphone apps for pain self-management. Pain Med. 2014 Jun;15(6):898–909. doi: 10.1111/pme.12327.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097–3. doi: 10.1371/journal.pmed.1000097.
    1. Techopedia. Mobile Application (Mobile App) .
    1. Scottish Intercollegiate Guidelines Network Critical appraisal notes and checklists .
    1. Blödt S, Pach D, Eisenhart-Rothe SV, Lotz F, Roll S, Icke K, Witt CM. Effectiveness of app-based self-acupressure for women with menstrual pain compared to usual care: a randomized pragmatic trial. Am J Obstet Gynecol. 2018 Feb;218(2):227.e1–9. doi: 10.1016/j.ajog.2017.11.570.
    1. Guillory J, Chang P, Henderson CR, Shengelia R, Lama S, Warmington M, Jowza M, Waldman S, Gay G, Reid MC. Piloting a text message-based social support intervention for patients with chronic pain: establishing feasibility and preliminary efficacy. Clin J Pain. 2015 Jun;31(6):548–56. doi: 10.1097/AJP.0000000000000193.
    1. Irvine AB, Russell H, Manocchia M, Mino DE, Cox GT, Morgan R, Gau JM, Birney AJ, Ary DV. Mobile-web app to self-manage low back pain: randomized controlled trial. J Med Internet Res. 2015 Jan 02;17(1):e1. doi: 10.2196/jmir.3130.
    1. Schatz J, Schlenz AM, McClellan CB, Puffer ES, Hardy S, Pfeiffer M, Roberts CW. Changes in coping, pain, and activity after cognitive-behavioral training: a randomized clinical trial for pediatric sickle cell disease using smartphones. Clin J Pain. 2015 Jun;31(6):536–47. doi: 10.1097/AJP.0000000000000183.
    1. Skrepnik N, Spitzer A, Altman R, Hoekstra J, Stewart J, Toselli R. Assessing the impact of a novel smartphone application compared with standard follow-up on mobility of patients with knee osteoarthritis following treatment with Hylan G-F 20: a randomized controlled trial. JMIR Mhealth Uhealth. 2017 May 09;5(5):e64. doi: 10.2196/mhealth.7179.
    1. Stinley NE, Norris D0, Hinds PS. Creating mandalas for the management of acute pain symptoms in pediatric patients. Art Ther (Alex) 2015 Jun 22;32(2):46–53. doi: 10.1080/07421656.2015.1028871.
    1. Sun Y, Jiang F, Gu JJ, Wang YK, Hua H, Li J, Cheng Z, Liao Z, Huang Q, Hu W, Ding G. 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. JMIR Mhealth Uhealth. 2017 Jul 25;5(7):e108. doi: 10.2196/mhealth.7178.
    1. Guétin S, Brun L, Deniaud M, Clerc J, Thayer JF, Koenig J. Smartphone-based music listening to reduce pain and anxiety before coronarography: a focus on sex differences. Altern Ther Health Med. 2016 Jul;22(4):60–3.
    1. Guétin S, Diego E, Mohy F, Adolphe C, Hoareau G, Touchon J, Thayer Jf, Koenig J. A patient-controlled, smartphone-based music intervention to reduce pain: A multi-center observational study of patients with chronic pain. Eur J Integr Med. 2016 Jun;8(3):182–7. doi: 10.1016/j.eujim.2016.01.002.
    1. Jamison RN, Mei A, Ross EL. Longitudinal trial of a smartphone pain application for chronic pain patients: predictors of compliance and satisfaction. J Telemed Telecare. 2018 Feb;24(2):93–100. doi: 10.1177/1357633X16679049.
    1. Jibb LA, Stevens BJ, Nathan PC, Seto E, Cafazzo JA, Johnston DL, Hum V, Stinson JN. Implementation and preliminary effectiveness of a real-time pain management smartphone app for adolescents with cancer: a multicenter pilot clinical study. Pediatr Blood Cancer. 2017 Oct;64(10) doi: 10.1002/pbc.26554.
    1. Lee M, Lee SH, Kim T, Yoo HJ, Kim SH, Suh DW, Son J, Yoon B. Feasibility of a smartphone-based exercise program for office workers with neck pain: an individualized approach using a self-classification algorithm. Arch Phys Med Rehabil. 2017 Dec;98(1):80–7. doi: 10.1016/j.apmr.2016.09.002.
    1. Oldenmenger WH, Baan MA, van der Rijt CC. Development and feasibility of a web application to monitor patients' cancer-related pain. Support Care Cancer. 2018 Feb;26(2):635–42. doi: 10.1007/s00520-017-3877-3.
    1. Raj SX, Brunelli C, Klepstad P, Kaasa S. COMBAT study - Computer based assessment and treatment - A clinical trial evaluating impact of a computerized clinical decision support tool on pain in cancer patients. Scand J Pain. 2017 Oct;17:99–106. doi: 10.1016/j.sjpain.2017.07.016.
    1. Huber S, Priebe JA, Baumann KM, Plidschun A, Schiessl C, Tölle TR. Treatment of low back pain with a digital multidisciplinary pain treatment app: short-term results. JMIR Rehabil Assist Technol. 2017 Dec 04;4(2):e11. doi: 10.2196/rehab.9032.
    1. Jamison RN, Jurcik DC, Edwards RR, Huang C, Ross EL. A pilot comparison of a smartphone app with or without 2-way messaging among chronic pain patients: who benefits from a pain app? Clin J Pain. 2017 Aug;33(8):676–86. doi: 10.1097/AJP.0000000000000455.
    1. NICE. National Institute for Health and Care Excellence - Low back pain and sciatica in over 16s: assessment and management 2016 .
    1. Kristjánsdóttir OB, Fors EA, Eide E, Finset A, Stensrud TL, van Dulmen S, Wigers SH, Eide H. A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: randomized controlled trial. J Med Internet Res. 2013 Jan 07;15(1):e5–62. doi: 10.2196/jmir.2249.
    1. Kristjánsdóttir OB, Fors EA, Eide E, Finset A, Stensrud TL, van Dulmen S, Wigers SH, Eide H. A smartphone-based intervention with diaries and therapist feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain. part 2: 11-month follow-up results of a randomized trial. J Med Internet Res. 2013 Mar 28;15(3):e72–7. doi: 10.2196/jmir.2442.
    1. Somers TJ, Abernethy AP, Edmond SN, Kelleher SA, Wren AA, Samsa GP, Keefe FJ. A pilot study of a mobile health pain coping skills training protocol for patients with persistent cancer pain. J Pain Symptom Manage. 2015 Oct;50(4):553–8. doi: 10.1016/j.jpainsymman.2015.04.013.
    1. Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Rogak L, Bennett AV, Dueck AC, Atkinson TM, Chou JF, Dulko D, Sit L, Barz A, Novotny P, Fruscione M, Sloan JA, Schrag D. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016 Feb 20;34(6):557–65. doi: 10.1200/JCO.2015.63.0830.
    1. Firth J, Torous J, Nicholas J, Carney R, Rosenbaum S, Sarris J. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J Affect Disord. 2017 Dec 15;218:15–22. doi: 10.1016/j.jad.2017.04.046.
    1. Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S, Sarris J. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017 Oct;16(3):287–98. doi: 10.1002/wps.20472. doi: 10.1002/wps.20472.
    1. Mira JJ, Navarro I, Botella F, Borrás F, Nuño-Solinís R, Orozco D, Iglesias-Alonso F, Pérez-Pérez P, Lorenzo S, Toro N. A Spanish pillbox app for elderly patients taking multiple medications: randomized controlled trial. J Med Internet Res. 2014 Apr 04;16(4):e99. doi: 10.2196/jmir.3269.
    1. Steinert A, Haesner M, Steinhagen-Thiessen E. [App-based self-monitoring in type 2 diabetes] Z Gerontol Geriatr. 2017 Aug;50(6):516–23. doi: 10.1007/s00391-016-1082-5.
    1. Glynn LG, Hayes PS, Casey M, Glynn F, Alvarez-Iglesias A, Newell J, OLaighin G, Heaney D, O'Donnell M, Murphy AW. Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. Br J Gen Pract. 2014 Jul;64(624):e384–91. doi: 10.3399/bjgp14X680461.
    1. Morawski K, Ghazinouri R, Krumme A, Lauffenburger JC, Lu Z, Durfee E, Oley L, Lee J, Mohta N, Haff N, Juusola JL, Choudhry NK. Association of a smartphone application with medication adherence and blood pressure control: the MedISAFE-BP randomized clinical trial. J Am Med Assoc Intern Med. 2018 Jun 01;178(6):802–9. doi: 10.1001/jamainternmed.2018.0447.
    1. Hurkmans E, Matthys C, Bogaerts A, Scheys L, Devloo K, Seghers J. Face-to-face versus mobile versus blended weight loss program: randomized clinical trial. JMIR Mhealth Uhealth. 2018 Jan 11;6(1):e14. doi: 10.2196/mhealth.7713.

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