A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain

Abstract

Context Pain coping skills training (PCST) interventions have shown efficacy for reducing pain and providing other benefits in patients with cancer. However, their reach is often limited because of a variety of barriers (e.g., travel, physical burden, cost, time). Objectives This study examined the feasibility and acceptability of a brief PCST intervention delivered to patients in their homes using mobile health (mHealth) technology. Pre-to-post intervention changes in pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing also were examined. Methods Patients with a diagnosis of breast, lung, prostate, or colorectal cancer who reported persistent pain (N=25) participated in a four-session intervention delivered using mHealth technology (video-conferencing on a tablet computer). Participants completed measures of pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing. We also assessed patient satisfaction. Results Participants completed an average of 3.36 (SD=1.11) of the four intervention sessions for an overall session completion rate of 84%. Participants reported that the program was of excellent quality and met their needs. Significant pre- to post-intervention differences were found in pain, physical symptoms, psychological distress, and pain catastrophizing. Conclusion The use of mHealth technology is a feasible and acceptable option for delivery of PCST for patients with cancer. This delivery mode is likely to dramatically increase intervention access for cancer patients with pain compared to traditional in-person delivery. Preliminary data also suggest that the program is likely to produce pre- to post-treatment decreases in pain and other important outcomes.

Use of Mobile Devices to Help Cancer Patients Meet Their Information Needs in Non-Inpatient Settings: Systematic Review (Preprint)

“…Weaver and colleagues [48] reported that patients felt more in control of their care and had increased confidence to self-manage their condition at home as a result of the intervention [48]. Similarly, Somers and colleagues [44] showed that 95% of participants reported that the intervention helped them to understand the experience of pain and 90% of participants felt the intervention had taught them skills that improved their pain coping; however, an observed increase in pain self-efficacy following the pain-related coping skills intervention was not significant. Finally, Fortier and colleagues [34] reported on the perceived usefulness of pain management strategies used by children, including self-talk, heat application and social support and suggested that this type of intervention provided patients with the opportunity to increase their self-efficacy in coping with pain during treatment.…”

“…Studies generally reported high adherence rates to the mobile interventions, regardless of the length of the study [28,30,31,35,43,44,45,[47][48][49]. A pilot RCT of 44 patients reported that patients used a handheld device consistently for an average of 10 weeks [35].…”

“…Additionally, studies highlighted that mobile interventions are able to capture patient information and outcomes that are not captured via conventional reporting, such as questionnaires [31,34,36,38,40,44,46,48]. However, an RCT of 112 breast, lung and colorectal cancer patients showed mixed results [37].…”

“…The majority of symptom-monitoring intervention studies further reported that patients perceived that the interventions had led to improved symptom management [31,35,38,39,41,44,48]. Head and colleagues [35] found that 52% of patients reported that they were much better and 44% somewhat better at managing their condition as a result of a handheld, symptom-monitoring intervention.…”

“…Head and colleagues [35] found that 52% of patients reported that they were much better and 44% somewhat better at managing their condition as a result of a handheld, symptom-monitoring intervention. A more recent feasibility study reported that participants showed significantly decreased pain severity, physical symptoms, psychological distress, and pain catastrophizing following a pain-coping skills intervention [44]. Similarly, Besse and colleagues [28] reported that the mean pain score of participants from the start to end of a feasibility study decreased non-significantly, but when measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the mean pain score decreased significantly from 56 to 35.…”