Background Digital health interventions can bridge barriers in access to treatment among individuals with chronic pain. Objective This study aimed to evaluate the perceived needs, engagement, and effectiveness of the mental health app Wysa with regard to mental health outcomes among real-world users who reported chronic pain and engaged with the app for support. Methods Real-world data from users (N=2194) who reported chronic pain and associated health conditions in their conversations with the mental health app were examined using a mixed methods retrospective observational study. An inductive thematic analysis was used to analyze the conversational data of users with chronic pain to assess perceived needs, along with comparative macro-analyses of conversational flows to capture engagement within the app. Additionally, the scores from a subset of users who completed a set of pre-post assessment questionnaires, namely Patient Health Questionnaire-9 (PHQ-9) (n=69) and Generalized Anxiety Disorder Assessment-7 (GAD-7) (n=57), were examined to evaluate the effectiveness of Wysa in providing support for mental health concerns among those managing chronic pain. Results The themes emerging from the conversations of users with chronic pain included health concerns , socioeconomic concerns , and pain management concerns . Findings from the quantitative analysis indicated that users with chronic pain showed significantly greater app engagement ( P <.001) than users without chronic pain, with a large effect size (Vargha and Delaney A =0.76-0.80). Furthermore, users with pre-post assessments during the study period were found to have significant improvements in group means for both PHQ-9 and GAD-7 symptom scores, with a medium effect size (Cohen d =0.60-0.61). Conclusions The findings indicate that users look for tools that can help them address their concerns related to mental health, pain management, and sleep issues. The study findings also indicate the breadth of the needs of users with chronic pain and the lack of support structures, and suggest that Wysa can provide effective support to bridge the gap.

BACKGROUND Digital health interventions can bridge barriers in access to treatment of care for individuals with chronic pain. OBJECTIVE This study aimed to evaluate the perceived needs, engagement and the effectiveness of the mental health app Wysa on mental health outcomes among real-world users who reported chronic pain and engaged with the app for support. METHODS Real-world data from users (N = 2,194) who reported chronic pain and associated health conditions in their conversations with a mental health app was analyzed using a mixed-method retrospective observational study. An inductive thematic analysis was used to analyse conversational data of users with chronic pain to assess perceived needs, along with comparative macro-analyses of conversational flows to capture engagement within the app. Additionally, the scores from a subset of users who completed a set of pre-post assessment questionnaires, namely PHQ-9 (N=69) and GAD-7 (N=57), were examined to evaluate the effectiveness of Wysa in providing support for mental health concerns for those managing chronic pain. RESULTS The themes emerging from the conversations of users with chronic pain included Health Concerns, Socioeconomic Concerns, and Pain Management Concerns. Findings from the quantitative analysis indicated that users with chronic pain showed significantly greater app engagement (p value <2.2e-16) than users without chronic pain, with a large effect size (Vargha and Delaney’s A- 0.76 -0.8). Furthermore, the sample of users with pre-post assessments during the study period were found to have significant improvements in group means on both PHQ-9 and GAD-7 symptom scores, with medium effect size (Cohens’d, 0.6-0.61), respectively. CONCLUSIONS The findings indicate that users look for tools that can help them address their concerns related to mental health, pain management, and sleep issues. The study findings also indicate the breadth of needs for users with chronic pain and the lack of support structures, and suggests that Wysa can provide effective support to bridge the gap.