JMIR Publications

ABSTRACT

Background:

Patients with chronic pain who are tapering prescription opioids report a need for greater support coping with symptoms of pain and withdrawal. Mobile health technologies (mHealth; SMS or app-based) have the potential to provide patients with educational, emotional, and motivational support for opioid tapering beyond that which is offered by their healthcare provider. However, it is not known whether patients with chronic pain who are tapering opioids would be willing or able to engage with technology-based support.

Objective:

To conduct research into (i) patients’ use of mobile technology, (ii) interest in using mHealth support, (iii) preferences for the form and content of mHealth support, and (iv) potential barriers to and facilitators of engagement with mHealth support for opioid tapering.

Methods:

Twenty-one patients (11 females, 10 males; age range = 29-83 years) with chronic noncancer pain on long term opioid therapy who had recently initiated a voluntary opioid taper were recruited from primary and tertiary care clinics in metropolitan and regional Australia for a larger study of patients’ experiences of opioid tapering. Participants had been taking prescription opioids for a mean duration of 13 years (SD= 9.6, range = .25-30 years) at the time of the study. Survey items characterized participants’ typical mobile phone use and level of interest in mobile technology-based support for opioid tapering. Semi-structured interviews further explored patient’s use of mobile technology, as well as their interest in, preferences for, and perspectives on potential barriers to and facilitators of engagement with mHealth support for opioid tapering. Two researchers collaborated to conduct thematic analysis of interview data.

Results:

All participants reported owning and using a mobile phone, and most (N=17, 81%) reported using mobile apps. The majority of participants expressed interest in SMS-based (N=17, 81%) and app-based (N=15, 71%) support for opioid tapering. Participants expected that messages delivering both informational and socioemotional support would be helpful. Participants expected that access to technology, mobile reception, internet connectivity, vision impairment, and low self-efficacy for using apps may be barriers to user engagement. Patients expected that continuity of care from their healthcare provider, flexible message “dosing”, responsivity, and familiarity with pain self-management strategies would increase user engagement.

Conclusions:

The findings of this research indicate that patients with chronic noncancer pain may be willing to engage with SMS and app-based mobile health interventions to support opioid tapering. However, the feasibility and acceptability of these interventions may depend on how patient preferences for functionality, content, and design are addressed.