Commercially Available Smartphone Apps to Support Postoperative Pain Self-Management: Scoping Review

Abstract

BackgroundRecently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning. Smartphone apps that provide remote real-time monitoring and symptom management have the potential to improve self-management skills in patients experiencing postoperative pain. Increased confidence and practice of self-management skills could contribute to decreased postoperative pain and reduce risk of developing persistent pain. Published reviews of general pain self-management apps demonstrate a lack of evidence-based content, theoretical grounding, and health care professional involvement. However, no review to date has focused on the app marketplace specific for individuals with postoperative pain.ObjectiveThe aim of this study was to characterize and critically appraise the content and functionality of commercially available postoperative pain self-management apps.MethodsAn electronic search and extraction was conducted between December 2016 and March 2017 of the official Canadian app stores for the three major smartphone operating systems (iPhone operating system [iOS], Android, and Windows). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the public app description. Metadata from all included apps were abstracted into a standard spreadsheet. Two authors verified the data with reference to the apps and downloaded apps themselves. The content and functionality of each app as it pertained to postoperative pain self-management was rated.ResultsA total of 10 apps met the inclusion criteria. All included apps were designed exclusively for the Android platform. Education was the most common self-management feature offered (8/10, 80%), with none of the apps offering features related to goal setting or social support. Overall, no single app was comprehensive in terms of pain self-management content. Five (50%) apps reported the involvement of a health care provider in their development. However, not a single app involved end users in their development, and none of the apps underwent scientific evaluation. Additionally, none of the apps were designed for use in pediatric patients.ConclusionsCurrently available postoperative pain apps for patients lack evidence-based content, goal setting, and social support functions. There is a need to develop and test comprehensive theory-based apps to support patients with pain self-management care following surgery.

Mobile Applications for Pain Management: Scoping Review (Preprint)

“…This problem has not been improved since Rosser and Eccleston's study in 2011. A study that reviewed postoperative pain self-management apps in 2017 reported 50% HCP involvement (5/10 apps) [24]. This percentage is much higher than percentages reported in other studies since we believe development of this type of pain app requires specialized medical knowledge.…”

“…To improve the usability of software, end-users -here patients with chronic pain -should be involved in software development. Only two studies (published in 2014 and 2017) were interested in the involvement of end-users and reported that they could not find any information about end-user involvement in pain apps and in postoperative pain self-management apps, respectively [17,24]. We found 7 apps (19%) involved end-users in development yet only in an ad-hoc way since we limited our study to pain apps with a pain diary function.…”

“…At least 11 review articles have been published evaluating pain management apps since 2011 [13][14][15][16][17][18][19][20][21][22][23]. Among them, 3 studies deal with specific forms of pain such as low back pain [21], postoperative pain [24], and pediatric pain [18]. Despite many published app reviews for the past several years, there are four reasons why we conducted this study.…”

“…First, the field of mHealth including pain management apps has rapidly changed so that apps are frequently updated with new features and new apps are released. For example, while a study published in 2011 (conducted in the summer in 2010) reported that 79% of the pain management apps were for Apple iOS and 16% were for Google Android [12], a study published in 2015 (conducted in 2014) reported that 64.2% of the apps were for Google Android and only 9% were for Apple iOS [19], and a study published in 2017 showed that 90.6% of the apps were for Android and 9.1% were for iOS [24].…”

Can mobile health apps replace GPs? A scoping review of comparisons between mobile apps and GP tasks

“…The findings suggest that mHealth apps have the potential to perform several specific clinical tasks that are conventionally performed by a GP. Previous studies have reported the roles of mHealth apps for patients with specific clinical goals, such as pain selfmanagement and weight management [28,29]. Such mobile app functions may replace several GP tasks, for example, an app for diagnosis could help users make decisions regarding further treatment options, therefore potentially replacing a GP for this purpose.…”