JMIR Publications

ABSTRACT

Background:

Digital tools can support chronic pain self-management, but their connection with professional support varies. Dual-facing digital health systems (DDHSs) integrate patient- and professional-facing components through shared data access, feedback, or communication. Understanding their characteristics and underpinning frameworks can inform their development and integration into care.

Objective:

This scoping review aimed to characterise DDHSs supporting adult chronic pain self-management, examine the use and reporting of frameworks informing their design, implementation, and evaluation, and identify gaps to guide future research.

Methods:

The review followed Joanna Briggs Institute methodology and PRISMA-ScR reporting guidance. MEDLINE, CINAHL, Embase, Scopus, Web of Science, and APA PsycINFO were searched in September 2025 for English-language, peer-reviewed primary research published from 2010 onwards, supplemented by backward citation searching. Eligible studies examined systems supporting self-management among adults with chronic pain and incorporating functionally integrated patient- and professional-facing components. Data were charted using a standardised form and synthesised descriptively at publication and system levels. Methodological and reporting quality was appraised using the Quality Assessment with Diverse Studies tool.

Results:

Searches identified 1377 records, with 822 remaining after deduplication. Nineteen publications representing 17 unique DDHSs were included. All systems supported patient tracking and professional access to patient-generated information. Two-way interaction was reported in 13/17 systems (76%), professional-facing messaging or feedback in 10/17 (59%), and explicit shared decision-making in 3/17 (18%). Systems primarily supported self-management with professional input (7/17, 41%), monitoring or communication (5/17, 29%), or integration with clinical workflows and care coordination (5/17, 29%). Engagement was evaluated in 15/19 publications (79%), clinical outcomes in 12/19 (63%), and feasibility in 11/19 (58%). Acceptance and Commitment Therapy informed three systems (18%), while explicit application of implementation and evaluation frameworks was limited. Professional workflows, governance responsibilities, and interoperability were inconsistently reported.

Conclusions:

DDHSs support chronic pain self-management through diverse configurations of patient-generated data and professional involvement. The extent of clinical integration varies, and evidence does not establish comparative effectiveness. Future research should specify how professionals review and act on patient-generated information, report governance arrangements, and explicitly connect system functions with theoretical mechanisms, implementation processes, and evaluation outcomes.