Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 10, 2018
Open Peer Review Period: Dec 11, 2018 - Dec 20, 2018
Date Accepted: Jan 13, 2019
(closed for review but you can still tweet)
Evaluation of Self-Management Support Functions in Apps for People with Persistent Pain: A Systematic Review
ABSTRACT
Background:
Smartphone applications (apps) are a potential mechanism for development of self-management skills in people with persistent pain. However, the inclusion of best practice content items in available pain management apps fostering core self-management skills for self-management support is not known.
Objective:
To evaluate the contents of smartphone apps for people with persistent pain facilitating self-management support and appraise the app quality.
Methods:
A systematic search was performed in the New Zealand App Store and Google Play Store. Apps were included if they were designed for people with persistent pain, provided information on pain self-management strategies and were available in English. App contents were evaluated using an a priori 14-item self-management support (SMS-14) checklist. App quality was assessed using the 23-item Mobile Apps Rating Scale.
Results:
Of the 939 apps screened, 19 apps met inclusion criteria. Meditation and guided relaxation were the most frequently included self-management strategies. Overall, the included apps met a median of 4 (range 1-8) of the SMS-14 checklist. Three apps (Curable, PainScale-Pain Diary and Coach and SuperBetter) met the largest number of items (8 out of 14) to foster self-management of pain. Self-monitoring of symptoms (n=11) and self-tailoring of strategies (n=9) were frequently featured functions, while few apps had features facilitating social support and communicating with clinicians. No apps provided information tailored to cultural needs of the user. The app quality mean scores using Mobile Apps Rating Scale ranged from 2.7 to 4.5 (out of 5.0). While use of two apps (Headspace and SuperBetter) have been shown to improve health outcomes, none of the included apps have been evaluated in people with persistent pain.
Conclusions:
Of the three apps (Curable, PainScale-Pain Diary and Coach and SuperBetter) that met the largest number of items to support skills in self-management of pain, two apps (PainScale-Pain Diary and Coach and SuperBetter) were free, suggesting the potential for using apps as a scalable, wide-reaching intervention to complement face-to-face care. However, none provided culturally-tailored information. While two apps (Headspace and SuperBetter) were validated to show improved health outcomes, none were tested in people with persistent pain. Both users and clinicians should be aware of such limitations and make informed choices in using or recommending apps as a self-management tool. For better integration of apps in clinical practice, concerted efforts are required among app developers, clinicians and people with persistent pain in developing apps, and evaluating for clinical efficacy. Clinical Trial: Not applicable
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