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. 2024 Feb;33(2):e6308.
doi: 10.1002/pon.6308.

Pain coping, multidisciplinary care, and mHealth: Patients' views on managing advanced cancer pain

Sara M DeForge  1 , Kyla Smith  1 , Kris-Ann Anderson  1 , Ashton R Baltazar  1 , Meghan Beck  2 , Andrea C Enzinger  3 , James A Tulsky  4 , Matthew Allsop  5 , Robert R Edwards  2 , Kristin L Schreiber  2 , Desiree R Azizoddin  1   4
Affiliations

Pain coping, multidisciplinary care, and mHealth: Patients' views on managing advanced cancer pain

Sara M DeForge et al. Psychooncology. 2024 Feb.

Abstract

Objective: Pain is common among people with advanced cancer. While opioids provide significant relief, incorporating psycho-behavioral treatments may improve pain outcomes. We examined patients' experiences with pain self-management and how their self-management of chronic, cancer-related pain may be complemented by behavioral mobile health (mHealth) interventions.

Methods: We conducted semi-structured qualitative interviews with patients with advanced cancer and pain. Each participant reviewed content from our behavioral mHealth application for cancer pain management and early images of its interface. Participants reflected on their experiences self-managing cancer pain and on app content. Interviews were transcribed verbatim and analyzed using a combination of inductive and deductive thematic analysis.

Results: Patients (n = 28; 54% female; mean age = 53) across two geographic regions reported using psychological strategies (e.g., reframing negative thoughts, distraction, pain acceptance, social support) to manage chronic cancer-related pain. Patients shared their perspectives on the integration of psycho-behavioral pain treatments into their existing medical care and their experiences with opioid hesitancy. Patient recommendations for how mHealth interventions could best support them coalesced around two topics: 1.) convenience in accessing integrated pharmacological and psycho-behavioral pain education and communication tools and 2.) relevance of the specific content to their clinical situation.

Conclusions: Integrated pharmacological and psycho-behavioral pain treatments were important to participants. This underscores a need to coordinate complimentary approaches when developing cancer pain management interventions. Participant feedback suggests that an mHealth intervention that integrates pain treatments may have the capacity to increase advanced cancer patients' access to destigmatizing, accessible care while improving pain self-management.

Keywords: advanced cancer; cancer; cancer pain; mHealth; oncology; pain-cognitive behavioral therapy; psycho-oncology.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

SMD, KS, KA, ARB, MB, JAT, RRE, and DRA have no conflicts to disclose. ACE receives research funding from Medtronic. MA receives funding through a research fellowship from Yorkshire Cancer Research. KLS serves on the editorial board of Anesthesiology, has received funding from Anesthesiology to attend an ANZCA meeting, has received payment or honoraria as a Grand Rounds speaker, and is the Vice Chair of Faculty Development in the Department of Anesthesiology, Brigham and Women's Hospital.

Figures

FIGURE 1
FIGURE 1
Zip codes of participants recruited from Dana-Farber Cancer Institute and Stephenson Cancer Center. Zip codes were categorized as rural or urban using RUCA code designations. One participant in urban Texas is not shown. Created with Datawrapper. RUCA, Rural-Urban Communting Area.
FIGURE 2
FIGURE 2
Example app wireframes and educational content reviewed by participants.
FIGURE 3
FIGURE 3
Primary topics identified in qualitative, semi-structured interviews with patients with advanced cancer and pain reflecting on their experiences self-managing pain and using mHealth apps for pain management support.
See this image and copyright information in PMC

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