Clinical utility of a mHealth assisted intervention for activity modulation in chronic pain: The pilot implementation
Nicole Emma Andrews1,2,3,4, David Ireland5, Michael Deen6,7
1RECOVER Injury Research Centre, The University of Queensland, Herston, Queensland, Australia.
Background:
Being able to successfully self-regulate one's activity levels is a key adaptation strategy for many people with chronic pain. This study aimed to explore the clinical utility of a mobile health platform (Pain ROADMAP) for assisting with the delivery of a tailored activity modulation intervention for people with persistent pain.
Methods:
Twenty adults with chronic pain undertook 1-week monitoring intervals which involved wearing an Actigraph activity monitor and entering pain, opioid use, and activity participation data into a custom-made phone app. The Pain ROADMAP online portal integrated and analysed the data to detect activities that caused a severe pain exacerbation and provided summary statistics pertaining the data collected. As part of a 15-week treatment protocol, participants received feedback from three dispersed Pain ROADMAP monitoring periods. Treatment focused on adapting pain-provoking activities, gradually increase goal-related activity and optimizing routine.
Results:
Results revealed good participant acceptability of monitoring procedures and reasonable adherence to both monitoring procedures and clinical follow-up appointments. Preliminary efficacy was established through clinically meaningful decreases in overactivity behaviour, pain variation, opioid use, depression, activity avoidance, and increases in productivity. No adverse outcomes were observed.
Conclusion:
The results of this study provide initial support for the clinical utility of mHealth assisted activity modulation interventions that involve remote monitoring.
Significance:
This is the first study to demonstrate how mHealth innovations that utilise ecological momentary assessment can be successfully integrated with wearable technologies to provide a tailored activity modulation intervention that is both highly valued by people with chronic pain and assists individuals to make constructive behavioural changes. Adaptions such as low costs sensors, increased customisability and gamification may be important for enhanced uptake, adherence and scalability.
