Informing the development of an Internet-based chronic pain self-management program

Area of Science:

• Health Informatics
• Digital Health
• Pain Management

Background:

• Chronic pain (CP) presents a significant and growing burden in Canada, necessitating optimized self-management strategies.
• Current healthcare practices often fail to integrate patient self-management into routine care, despite its potential to improve outcomes.
• Health information technology offers a promising avenue for enhanced patient-care team communication and monitoring in CP management.

Purpose of the Study:

• To identify critical information needs and existing gaps in chronic pain management.
• To determine essential technology features for developing an effective Internet-based self-management program for chronic pain.
• To inform the design of a digital health solution to support chronic pain self-management.

Main Methods:

• A structured literature review of electronic databases (up to 2015) using keywords related to chronic pain, self-management, and e-health.
• Narrative synthesis of 39 primary articles on 20 Internet-based pain management programs to identify characteristics and content.
• Thematic analysis of focus group transcripts from individuals with chronic pain, caregivers, and health professionals (n=16) from multidisciplinary centers.

Main Results:

• Identified gaps in chronic pain management include insufficient patient knowledge, limited healthcare access, suboptimal care, and inadequate self-management support.
• Fourteen themes regarding information needs and care gaps were identified, with common topics including patient education, attitudes, financial/legal issues, and motivation.
• Focus groups highlighted the need for functionalities not present in existing programs, such as non-medical information, condition-specific content, and personal health record integration.

Conclusions:

• Internet-based programs can bridge information and care gaps through automated features, communication tools, and decision support.
• Future program development should incorporate patient- and clinician-identified needs, including personalized content and integration of diverse health professionals' roles.
• Interactivity, personalization, tailored messaging, and therapist contact are key components for maximizing the effectiveness of Internet-based chronic pain self-management programs.