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Randomized Controlled Trial
. 2019 May 29;7(5):e12542.
doi: 10.2196/12542.

Development and Testing of a Mobile App for Pain Management Among Cancer Patients Discharged From Hospital Treatment: Randomized Controlled Trial

Jing Yang #  1   2 , Lizhu Weng #  2   3 , Zhikui Chen  4 , Hongfu Cai  1   2 , Xiaoyan Lin  5 , Zhijian Hu  6 , Na Li  1   2 , Bijuan Lin  1   2 , Bin Zheng  1   2 , Qian Zhuang  1   2 , Bin Du  5 , Zhiyuan Zheng  2 , Maobai Liu  1   2
Affiliations
Randomized Controlled Trial

Development and Testing of a Mobile App for Pain Management Among Cancer Patients Discharged From Hospital Treatment: Randomized Controlled Trial

Jing Yang et al. JMIR Mhealth Uhealth. .

Abstract

Background: The incidence of cancer pain increases in discharged patients because of discontinued standard treatments and reductions in medication adherence. Motivated by the need for better pain management in discharged patients, we developed a mobile phone app (Pain Guard) to provide continuous treatment information and feedback to discharged cancer patients suffering from pain.

Objective: The aim was to design, construct, and test the Pain Guard app in patients managing cancer pain, evaluate the total remission rate of pain and the improvement in quality of life (QoL) to improve pain management for cancer pain patients, and assess patient acceptance of the app.

Methods: This randomized controlled double-arm study involved 58 patients with cancer pain symptoms. Participants were randomly assigned to a group receiving care through the Pain Guard app (n=31) or to a control group (n=27) who received only traditional pharmaceutical care. In a pretest, participants were rated using a baseline cancer pain assessment and QoL evaluation. During treatment, the consumption levels of analgesic drugs were recorded every week. After a 4-week study period, another round of cancer pain assessment and QoL evaluation was conducted. The system's usability, feasibility, app compliance, and satisfaction were also assessed. Our primary outcome was remission rate of pain, and secondary outcomes were medication adherence, improvements in QoL, frequency of breakthrough cancer pain (BTcP), incidence of adverse reactions, and satisfaction of patients.

Results: All participants (N=58) successfully completed the study. There were no significant differences in baseline pain scores or baseline QoL scores between groups. At the end of the study, the rate of pain remission in the trial group was significantly higher than that in the control group (P<.001). The frequency of BTcP in the app group was considerably lower than that in the control group (P<.001). The rate of medication adherence in the trial group was considerably higher than that in the control group (P<.001). Improvements in global QoL scores in the trial group were also significantly higher than those in the control group (P<.001). The incidence of adverse reactions in the trial group (7/31) was lower than that in the control group (12/27), especially constipation, with significant differences (P=.01). The 31 participants in the trial group completed a satisfaction survey regarding Pain Guard: 23 (74%) indicated that they were satisfied with receiving pharmaceutical care by Pain Guard, 5 (16%) indicated that they were somewhat satisfied, 2 (6%) indicated neutral feelings, and 1 (3%) indicated that they were somewhat dissatisfied; no participants indicated that they were very dissatisfied.

Conclusions: Pain Guard was effective for the management of pain in discharged patients with cancer pain, and its operability was effective and easily accepted by patients.

Trial registration: Chinese Clinical Trials Registry ChiCTR1800016066; http://www.chictr.org.cn/showproj.aspx?proj=27153.

Keywords: adherence; cancer; pain management; quality of life.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Screenshot of the medical experts’ search page.
Figure 2
Figure 2
Screenshot of the patient app home page.
Figure 3
Figure 3
Screenshot of the self-evaluation module, including the pain diary and breakthrough cancer pain assessment parts.
Figure 4
Figure 4
Screenshots of the reminds, records, and report center modules.
Figure 5
Figure 5
Screenshot of the real-time medication consultation module.
Figure 6
Figure 6
Screenshot of the soothing music treatment module.
Figure 7
Figure 7
Screenshot of the pharmaceutical moment module.
Figure 8
Figure 8
Screenshot of the My Center module.
Figure 9
Figure 9
Adverse reactions profile of participants during the study (N=58).
See this image and copyright information in PMC

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