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Feasibility research into digital pain treatment

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Earlier this year, Activos – Pain Education & Training, along with exercise therapist Mensendieck Oefentherapie Davidse, initiated a collaboration with Digital Health Lab (DHL) and University College Roosevelt (UCR). The goal of this collaboration is to develop a smartphone app for chronic pain patients who are treated within the Activos training program. 

Motivation

Despite the rapidly increasing number of smartphone apps available in the health sector (1, 2), there are very few regulations on what can be marketed as a pain management app for chronic pain patients (3). Surprisingly, the majority of the apps fail to provide scientific evidence that they are beneficial to the patient, and it is very rare for healthcare professionals or pain management specialists to be involved in the app’s development process (4).

Therefore, Digital Health Lab started a research project with Activos, Oefentherapie Davidse and University College Roosevelt. For a year, scientific and practical research will be conducted on the medical, technical, and economic feasibility of developing a smartphone app in order to digitalize the effective treatment program of Activos for chronic pain patients. 

Moreover, patients, pain specialists, and other partners in the health sector will be actively involved in the research activities and the development of the app. This research is co-financed by a subsidy of the Province Zeeland. 

Activos

Activos offers a unique treatment program that focuses on pain education and training (5). There are several locations in the Netherlands where the program is offered. The program is taught by Anja Wijdemans, a pain management nurse, and Janine Davidse, an exercise therapist Mensendieck specialized in chronic pain. The program is unique, because it is among the first to apply a biopsychosocial approach to chronic pain management (5, 6). 

The Activos program focuses on increasing feelings of self-efficacy, ultimately aiming to improve each client’s ability to self-manage their own unique pain symptoms and rely less on medical treatments. Clients are educated on the physical mechanisms underlying pain and pain perception, and taught techniques to monitor their daily pain experiences in order to identify specific activities or routines that could be altered to reduce their pain symptoms (5).

Target group

Activos’s target group consists of chronic pain patients. To be classified as chronic, the pain must have lasted for three months or longer and must fail to serve a clear biological purpose (7, 8). For example, chronic pain would not directly result from a clear physical injury, such as a broken bone or open wound. (7)

Due to a number of issues, such as the lack of healthcare professionals specialized in chronic pain, difficulties with transportation, and monetary restrictions, many suffering from chronic pain are unable to access the care that they need (9-11). 

Luckily eHealth solutions are developing quickly. With this comes the increased possibility of creating a smartphone app to support chronic pain patients on an individual level when managing their pain symptoms (1, 2, 12). Moreover, the app can be adjusted to their personal needs and can be used in the comfort of their own home (12-14). 

Are you a patient, health care professional of for any other reason interested in this project? Please feel free to contact Milou van Belzen by e-mail (info@caseelements.nl) or telephone (0031 622 234 521). 

References

  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. Clinical Journal of Pain [Internet]. 2015 May 18 [cited 2021 Jul 1];31(6):557–63. Available from: https://journals.lww.com/clinicalpain/Fulltext/2015/06000/_There_s_a_Pain_App_for_That___Review_of.9.aspx
  2. Thomas, Janssen L, Pronk Y, Zwaard BC van der, Koëter S, Oostveen D van, et al. Assessing the Efficacy of an Educational Smartphone or Tablet App With Subdivided and Interactive Content to Increase Patients’ Medical Knowledge: Randomized Controlled Trial. JMIR Mhealth Uhealth 2018;6(12):e10742 https://mhealth.jmir.org/2018/12/e10742 [Internet]. 2018 Dec 21 [cited 2021 Aug 1];6(12):e10742. Available from: https://mhealth.jmir.org/2018/12/e10742
  3. Zhao P, Yoo I, Lancey R, Varghese E. Mobile applications for pain management: an app analysis for clinical usage. BMC Medical Informatics and Decision Making [Internet]. 2019 Dec;19(1):106. Available from: https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0827-7
  4. Boudreaux ED, Waring ME, Hayes RB, Sadasivam RS, Mullen S, Pagoto S. Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations. Translational Behavioral Medicine [Internet]. 2014 Dec;4(4):363–71. Available from: https://doi.org/10.1007/s13142-014-0293-9
  5. Activos – Pain Education & Training [Internet]. [cited 2021 Aug 9]. Available from: https://www.activos.nl/
  6. Fischer A, Herrmann V, Thomas T, Vos K, Baker M, Collett B, et al. The Pain Proposal: Improving the current and future management of chronic pain A European consensus report – The Pain Proposal Steering Committee Acknowledgements.
  7. International Association for the Study of Pain. Right to Pain Relief- IASP [Internet]. IASP – Global Year. 2018. Available from: https://www.iasp-pain.org/GlobalYear/RighttoPainRelief
  8. IASP Task Force on Taxonomy. IASP Terminology – IASP [Internet]. International Association for the Study of Pain: Working Together for Pain Relief. 1994. Available from: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698&navItemNumber=576
  9. Roberts A, Philip L, Currie M, Mort A. Striking a balance between in-person care and the use of eHealth to support the older rural population with chronic pain. International Journal of Qualitative Studies on Health and Well-being [Internet]. 2015 Jan;10(1):27536. Available from: https://www.tandfonline.com/doi/full/10.3402/qhw.v10.27536
  10. Kreps GL, Neuhauser L. New directions in eHealth communication: Opportunities and challenges. Patient Education and Counseling [Internet]. 2010 Mar;78(3):329–36. Available from: https://www.sciencedirect.com/science/article/pii/S0738399110000224
  11. Fischer A, Herrmann V, Thomas T, Vos K, Baker M, Collett B, et al. The Pain Proposal: Improving the current and future management of chronic pain A European consensus report – The Pain Proposal Steering Committee Acknowledgements. 
  12. Rowland SP, Fitzgerald JE, Holme T, Powell J, McGregor A. What is the clinical value of mHealth for patients? npj Digital Medicine 2020 3:1 [Internet]. 2020 Jan 13 [cited 2021 Aug 2];3(1):1–6. Available from: https://www-nature-com.proxy.library.uu.nl/articles/s41746-019-0206-x
  13. Devan H, Farmery D, Peebles L, Grainger R. Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review [Internet]. Vol. 7, JMIR mHealth and uHealth. JMIR Publications Inc.; 2019 [cited 2021 Jul 1]. p. e13080. Available from: https://mhealth.jmir.org/2019/2/e13080
  14. Hemakumar, Farmery D, Peebles L, Grainger R. Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review. JMIR Mhealth Uhealth 2019;7(2):e13080 https://mhealth.jmir.org/2019/2/e13080 [Internet]. 2019 Feb 12 [cited 2021 Aug 1];7(2):e13080. Available from: https://mhealth.jmir.org/2019/2/e13080
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