JMIR Publications

ABSTRACT

Background:

Advanced cancer patients often experience poorly managed pain.

Objective:

We evaluated the feasibility and acceptability of MyPainPal, a mobile health (mHealth) application that combines daily symptom and opioid-use surveys, algorithmic self-management support, psychoeducation, and clinician monitoring.

Methods:

This single-arm pilot study enrolled adults with advanced malignancies using opioids for moderate-to-severe pain from a major cancer center’s palliative care clinic. Participants used the app for 28 days; nurses monitored symptoms on a secure portal. Patients assessed usability and acceptability assessments. Semi-structured patient debriefing interviews explored app utilization, perceived impact, and optimization strategies.

Results:

Twenty participants (mean age 57[SD=12.3], 55% female, 80% White with mixed cancer types enrolled, used MyPainPal a median of 14 times (IQR:8,17), and completed 8 symptom surveys (IQR:5,14) reflecting 36% (SD:20%) of eligible (out-of-hospital) days on study. Participants found the app acceptable; mean system usability scale=78.3/100 (SD=16.2); 79% rated their overall satisfaction as ≥4/5. Twenty percent of surveys generated an alert, prompting nurse outreach. In response, five participants had symptom medications changed and two had medication errors corrected. Participants described reduced barriers to pain reporting and facilitated constructive interactions with care teams, and several noted it validated their pain experience, reduced opioid stigma, and promoted self-management. Patients recommended featuring educational resources more prominently, modifying symptom surveys, and introducing MyPainPal earlier in their pain trajectory.

Conclusions:

MyPainPal demonstrated feasibility, acceptability, and preliminary evidence of clinical impact. In response, the app is being adapted for a future efficacy study. Clinical Trial: NCT03717402