eDOL mHealth App and Web Platform for Self-monitoring and Medical Follow-up of Patients With Chronic Pain: Observational Feasibility Study (Preprint)

Abstract

BACKGROUND The pharmacopoeia of analgesics is old, their effectiveness is limited, with undesirable effects and little progress has been made in recent years. Thus, innovation is limited despite prolific basic research. Better characterization of patients could help to identify the predictors of successful treatments through research programs, and therefore enable physicians to carry out better decision-making in the initial choice of treatment and in the follow-up of their patients. Nevertheless, the current assessment of chronic pain patients provides only fragmentary data on their painful daily experiences. Thus, it is essential to modify the temporality in which patients’ sensations are assessed, with real-life monitoring of different parameters, i.e. subjective and objective markers of chronic pain. Consequently, recent studies have highlighted the urgent need to develop self-management and chronic pain management programs through e-health programs, and enhance their therapeutic value. OBJECTIVE We hypothesize that regular patient self-monitoring using an mHealth application would lead physicians to obtain deeper knowledge and a new vision of chronic pain patients, while for patients it would play a positive therapeutic role, as they become active in their own management and benefit from online advice. Such an assessment would not only contribute to better patient characterization and help in the choice of the most appropriate treatment, but could also improve adherence to treatment. To address this issue, we evaluated the feasibility and acceptability, by patients and physicians, of a new mHealth application called eDOL. METHODS An observational study assessing the feasibility and acceptability of the eDOL tool was conducted. Patients completed several questionnaires via eDOL over a period of 2 weeks, and then repeatedly over a period of 3 months. Physicians saw their patients at a follow-up visit that took place at least 3-months after the inclusion visit. The primary endpoint, a composite criterion reflecting the acceptability of eDOL and the feasibility of its use, was assessed using satisfaction questionnaires for both patients and physicians after the completion of study. RESULTS One hundred and thirty-three patients were included of whom 105 were analyzable. Our results showed a rate of adherence of approximately 60% of patients after 3 months of using eDOL, a median acceptability score around 7/10 for both patients and physicians, a high rate of completion of the baseline questionnaires / meters, and a low rate for follow-up questionnaires / meters and forms. We were also able to characterize subgroups of patients and determine a profile of those who adhered to eDOL. CONCLUSIONS This work demonstrates that eDOL is highly feasible and acceptable for both chronic pain patients and their physicians. It also shows that such a tool can integrate many parameters to ensure the detailed characterization of patients for future research works and pain management. CLINICALTRIAL NCT03931694