Benefits of Mobile Apps in Pain Management: Systematic Review

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.

[1]  C. McClellan,et al.  Changes in Coping, Pain, and Activity After Cognitive-Behavioral Training: A Randomized Clinical Trial for Pediatric Sickle Cell Disease Using Smartphones , 2015, The Clinical journal of pain.

[2]  C. C. van der Rijt,et al.  Development and feasibility of a web application to monitor patients’ cancer-related pain , 2017, Supportive Care in Cancer.

[3]  C. Eccleston,et al.  Smartphone applications for pain management , 2011, Journal of telemedicine and telecare.

[4]  Jan Seghers,et al.  Face-to-Face Versus Mobile Versus Blended Weight Loss Program: Randomized Clinical Trial , 2018, JMIR mHealth and uHealth.

[5]  Ehsan Nabovati,et al.  Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects , 2017, Applied Clinical Informatics.

[6]  T. Tölle,et al.  Treatment of Low Back Pain with a Digital Multidisciplinary Pain Treatment App: Short-Term Results , 2017, JMIR rehabilitation and assistive technologies.

[7]  Cinzia Brunelli,et al.  COMBAT study – Computer based assessment and treatment – A clinical trial evaluating impact of a computerized clinical decision support tool on pain in cancer patients , 2017, Scandinavian journal of pain.

[8]  Charmian Reynoldson,et al.  Assessing the quality and usability of smartphone apps for pain self-management. , 2014, Pain medicine.

[9]  John Torous,et al.  Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. , 2017, Journal of affective disorders.

[10]  A. Abernethy,et al.  A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain. , 2015, Journal of pain and symptom management.

[11]  J. Thayer,et al.  Smartphone-based Music Listening to Reduce Pain and Anxiety Before Coronarography: A Focus on Sex Differences. , 2016, Alternative therapies in health and medicine.

[12]  John Torous,et al.  The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials , 2017, World psychiatry : official journal of the World Psychiatric Association.

[13]  Leslie Oley,et al.  Association of a Smartphone Application With Medication Adherence and Blood Pressure Control: The MedISAFE-BP Randomized Clinical Trial , 2018, JAMA internal medicine.

[14]  Pamara F. Chang,et al.  Piloting a Text Message–based Social Support Intervention for Patients With Chronic Pain: Establishing Feasibility and Preliminary Efficacy , 2015, The Clinical journal of pain.

[15]  J. Thayer,et al.  A patient-controlled, smartphone-based music intervention to reduce pain—A multi-center observational study of patients with chronic pain , 2016 .

[16]  D. Moher,et al.  Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement , 2009, BMJ : British Medical Journal.

[17]  Deborah Schrag,et al.  Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  Robert R. Edwards,et al.  A Pilot Comparison of a Smartphone App With or Without 2-Way Messaging Among Chronic Pain Patients , 2016, The Clinical journal of pain.

[19]  O. Kristjansdottir,et al.  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 , 2013, Journal of medical Internet research.

[20]  Y. K. Wang,et al.  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 , 2017, JMIR mHealth and uHealth.

[21]  Joseph A Cafazzo,et al.  Implementation and preliminary effectiveness of a real‐time pain management smartphone app for adolescents with cancer: A multicenter pilot clinical study , 2017, Pediatric blood & cancer.

[22]  M. O’Donnell,et al.  Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. , 2014, The British journal of general practice : the journal of the Royal College of General Practitioners.

[23]  J. Stinson,et al.  “There’s a Pain App for That”: Review of Patient-targeted Smartphone Applications for Pain Management , 2015, The Clinical journal of pain.

[24]  Minyoung Lee,et al.  Feasibility of a Smartphone-Based Exercise Program for Office Workers With Neck Pain: An Individualized Approach Using a Self-Classification Algorithm. , 2017, Archives of physical medicine and rehabilitation.

[25]  D. Walsh Guidelines and recommendations for managing challenging chronic pain conditionsI83. The National Institute for Health and Care Excellence Revised Guidelines for the Management of Non-Specific Low Back Pain and Sciatica , 2017 .

[26]  M. Nie,et al.  T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis , 2016, PloS one.

[27]  R. Jamison,et al.  Longitudinal trial of a smartphone pain application for chronic pain patients: Predictors of compliance and satisfaction , 2016, Journal of telemedicine and telecare.

[28]  R. Altman,et al.  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 , 2017, JMIR mHealth and uHealth.

[29]  Jordan Rivera,et al.  Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review , 2017, JMIR mHealth and uHealth.

[30]  C. Witt,et al.  Effectiveness of app‐based self‐acupressure for women with menstrual pain compared to usual care: a randomized pragmatic trial , 2017, American journal of obstetrics and gynecology.

[31]  O. Kristjansdottir,et al.  A Smartphone-Based Intervention With Diaries and Therapist-Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain: Randomized Controlled Trial , 2013, Journal of medical Internet research.

[32]  Tony O’Brien,et al.  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 , 2013, BMC Public Health.

[33]  Osman H Ahmed,et al.  Smartphone apps for the self-management of low back pain: A systematic review. , 2016, Best practice & research. Clinical rheumatology.

[34]  J. Gau,et al.  Mobile-Web App to Self-Manage Low Back Pain: Randomized Controlled Trial , 2015, Journal of medical Internet research.

[35]  J. Phillips,et al.  Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review , 2018, Pain medicine.

[36]  M. Haesner,et al.  App-basiertes Selbstmonitoring bei Typ-2-Diabetes , 2016, Zeitschrift für Gerontologie und Geriatrie.

[37]  Eleni Stroulia,et al.  Improved A1C Levels in Type 1 Diabetes with Smartphone App Use. , 2017, Canadian journal of diabetes.

[38]  Lorraine S Wallace,et al.  A systematic review of smartphone applications for chronic pain available for download in the United States. , 2014, Journal of opioid management.

[39]  Federico Botella,et al.  A Spanish Pillbox App for Elderly Patients Taking Multiple Medications: Randomized Controlled Trial , 2014, Journal of medical Internet research.

[40]  Pamela Portelli,et al.  A quality review of smartphone applications for the management of pain , 2016, British journal of pain.

[41]  P. Hinds,et al.  Creating Mandalas for the Management of Acute Pain Symptoms in Pediatric Patients , 2015 .

[42]  G. Teilmann,et al.  Exploring the Influence of a Smartphone App (Young with Diabetes) on Young People’s Self-Management: Qualitative Study , 2018, JMIR mHealth and uHealth.