Evaluating the Impact of an mHealth Platform for Managing Acute Post-Operative Dental Pain: A Randomized Controlled Trial (Preprint)

Abstract

UNSTRUCTURED Background Post-operative dental pain is pervasive and can significantly affect a patient's quality of life. Adopting a patient-centric approach to pain management involves having contemporaneous information about the patient's experience of pain, and using it to personalize care. In this study, we evaluated the use of an mHealth platform to collect pain-related patient reported outcomes (PROs) over 7-days after pain-inducing dental procedures, relayed the information to the dentist, and determined its impact on the patient pain experience. Methods The study employed a cluster-randomized experimental study design with: (1) an intervention arm where patients were prompted to complete a series of questions relating to their pain experience after text notifications on their smartphone on Days 1, 3, 5 and 7, with the resulting information fed back to dentists; and (2) a control arm where patients received usual care. Provider interviews and surveys were conducted to evaluate acceptance of the mHealth platform. Results A total of 42 providers and 1,525 patients participated. No significant difference was detected on the primary outcome of pain intensity experienced by patients in the control vs intervention arms. There were also no significant differences in secondary outcomes including pain interference, patient satisfaction, or opioid prescribing. Provider acceptance of use of the mHealth application was high. Conclusion While the mHealth platform did not have a significant impact on acute postoperative pain experience, patients and providers indicated improvement in patient-provider communication, patient-provider relationship, post-operative complication management, and ability to manage pain medication prescribing. Expanded collaboration between mHealth developers and frontline healthcare providers can facilitate the applicability of these platforms, further help improve its integration with normal clinic workflow, and assist in moving towards a more patient-centric approach to pain management.