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. 2021 Jun 3;18(11):5991.
doi: 10.3390/ijerph18115991.

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Francisco Villegas  1 , Verónica Martínez-Borba  2   3 , Carlos Suso-Ribera  2 , Diana Castilla  4   5 , Irene Zaragoza  5 , Azucena García-Palacios  2   5 , Carlos Ferrer  1
Affiliations

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings

Francisco Villegas et al. Int J Environ Res Public Health. .

Abstract

Background: mobile applications (apps) facilitate cancer pain ecological momentary assessment (EMA) and provide more reliable data than retrospective monitoring. The aims of this study are (a) to describe the status of persons with cancer pain when assessed ecologically, (b) to analyze the utility of clinical alarms integrated into the app, and (c) to test the feasibility of implementing an app for daily oncological pain monitoring.

Methods: in this feasibility study, 21 patients (mean age = 56.95 years, SD = 10.53, 81.0% men) responded to an app-based evaluation of physical status (baseline and breakthrough cancer pain (BTcP)) and mental health variables (fatigue, mood, and coping) daily during 30 days.

Results: cancer pain characterization with the app was similar to data from the literature using retrospective assessments in terms of BTcP duration and perceived medication effectiveness. However, BTcP was less frequent when evaluated ecologically. Pain, fatigue, and mood were comparable in the morning and evening. Passive coping strategies were the most employed daily. Clinical alarms appear to be useful to detect and address adverse events. App implementation was feasible and acceptable.

Conclusion: apps reduce recall bias and facilitate a rapid response to adverse events in oncological care. Future efforts should be addressed to integrate EMA and ecological momentary interventions to facilitate pain self-management via apps.

Keywords: breakthrough cancer pain; ecological momentary assessment; pain characterization; pain management; smartphone application.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Graphical Representation of Happiness Over the Study.
Figure A2
Figure A2
Graphical Representation of Sadness Over the Study.
Figure A3
Figure A3
Graphical Representation of Anxiety Over the Study.
Figure 1
Figure 1
On-demand, breakthrough pain assessment algorithm.
Figure 2
Figure 2
Evolution of baseline pain in the morning and evening during the study based on ecological momentary assessment with the app.
Figure 3
Figure 3
Evolution of fatigue in the morning and evening during the study based on ecological momentary assessment with the app.
Figure 4
Figure 4
Perceived relief of baseline medication for pain.
Figure 5
Figure 5
Use of strategies to cope with the pain (aggregate of daily reports).
See this image and copyright information in PMC

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