In one of the first studies of its kind, researchers in Norway have found that smartphone applications can be effective in helping women manage chronic pain.
“Web-based programs delivered via smartphones are increasingly used to support the self-management of various health disorders, but research on smartphone interventions for persons with chronic pain is limited,” the authors reported in the Journal of Medical Internet Research.
“Our results give preliminary support to the efficacy of a smartphone intervention for catastrophizing, acceptance, functioning, and symptom level in women with chronic widespread pain.”
A total of 140 women suffering from chronic pain for at least six months were treated at a rehabilitation center in Moss, Norway. Treatment procedures included a month long inpatient rehabilitation program consisting of pain education, pain management information, aerobic exercise, group discussions, and relaxation instructions.
The women were then randomly assigned to two groups: one with smartphone intervention and one without. Both groups continued to consult with a pain therapist.
The smartphone group was instructed to record three daily “journal-type” entries using their smartphone apps. The web-based diaries consisted of 16 to 24 questions relating to their pain level, thoughts about pain, and pain acceptance. The diary entries were immediately available to a therapist, who gave written personalized feedback to the women on managing their pain.
Of the 112 women who completed the study, researchers say the smartphone group reported less pain than the control group that didn’t use a smartphone app.
“The results from the per-protocol analysis indicate that this intervention with diaries and written personalized feedback reduced catastrophizing and increased acceptance in women with chronic widespread pain and that these effects persisted 5 months after the intervention,” said lead author Ólöf Birna Kristjánsdóttir of the Department of Behavioral Sciences in Medicine at the University of Oslo.
At the 5-month follow-up, researchers said the control group experienced increased emotional distress, while the smartphone group did not.
“The results suggest that a smartphone-delivered intervention with diaries and personalized feedback can reduce catastrophizing and prevent increases in functional impairment and symptom levels in women with chronic widespread pain following inpatient rehabilitation,” said Kristjánsdóttir.
In recent years, dozens of chronic pain and other health apps, such as My Pain Diary, have come on the market claiming to offer relief for pain patients. But there is little evidence that mobile health or “mHealth” actually works, according to one researcher.
“The current wave of mHealth interventions are the equivalent of black boxes. Each small entrepreneur or researcher includes whatever bells and whistles that their funding allows in an attempt to demonstrate efficacy,” said Mark Tomlinson from Stellenbosch University in South Africa. “In some ways, mobile technology has a magical appeal for those interested in global public health over and above the advantages that have been proven with good evidence.”
At a recent mHealth conference in South Africa, Tomlinson said there were repeated calls for a scale up of mHealth initiatives in low and middle-income countries.
“Many of these calls emanated from industry representatives rather than researchers, governments, or care providers. It is likely that private enterprise has a quite different understanding of what scale up means, with growing market share, rather than improved health outcomes, at the core of their mission. The growing involvement by industry, predominantly mobile phone providers, warrants some caution in addition to perhaps a code of practice,” Tomlinson wrote in an article published in PLOS Medicine.
Tomlinson said a robust set of standards should be developed for mobile health applications and platforms to serve the world’s 6 billion mobile phone subscribers.