Interest in Digital Peer-Delivered Interventions and Preferences to Improve Pain Self-efficacy and Reduce Loneliness Among Patients With Chronic Pain: Mixed Methods Co-design Study (Preprint)

Abstract

BACKGROUND Two important factors that prolong and exacerbate chronic non-cancer pain (CNCP) and disability are pain self-efficacy and social connectedness. Yet the availability of pain treatments that target social connectedness and loneliness are limited and often overlooked, and few interventions have shown long-term sustained improvements in pain self-efficacy. More effective and accessible treatments designed to target these modifiable factors could ease the burden of CNCP. OBJECTIVE To inform co-design of new and innovative digital peer support interventions to increase pain self-efficacy, pain-related outcomes, and quality of life, this study examined patient interest in digital peer-delivered interventions for CNCP and potential factors associated with interest (pain self-efficacy; loneliness). It also explored preferences for peer-delivered support as well as implementation barriers and enablers. METHODS This cross-sectional mixed-methods study was part of a larger longitudinal cohort study. Individuals (N = 186) with CNCP for 3-months or longer diagnosed by a medical professional or pain specialist, who resided in Australia, and were 18 years or over were included in this study if they also completed a subsequent survey in wave 3 (Nov 2021-Jan-2022) examining interest and preferences for digital peer-delivered interventions. Participants were initially recruited through online advertising on professional pain social media accounts and websites. Questions examined whether patients were interested in digital peer-delivered interventions (yes, no) and their preferences for specific features (e.g., Newsfeed). Possible factors associated with level of interest including pain self-efficacy and loneliness were assessed using validated questionnaires. Open-ended questions explored implementation barriers, enablers, and suggestions for consideration in intervention design. RESULTS There was interest in a digital peer-delivered interventions, with almost half of the sample indicating that they would access it if it was available. Those who indicated interest in digital peer interventions reported both lower pain self-efficacy and greater loneliness than those who were not interested. Intervention content that incorporated education and links to health services and resources as well as delivery of support by peer coaches were the most frequently preferred intervention features. Three potential benefits were identified: Shared experience; Social Connection; and Shared pain management solutions. Five potential barriers were identified: Negative focus on pain; Judgement; Lack of engagement; Negative impact on mental health; Privacy and security concerns; and Unmet personal preferences. Finally, there were eight suggestions from participants: Moderation of the group; Interest sub-groups; Professional-led activities; Psychological strategies; Links to professional pain resources; Newsletter; Motivational Content; Live streaming and online meet-ups. CONCLUSIONS Digital peer-delivered interventions particularly interested those with CNCP who had lower levels of pain self-efficacy and higher levels of loneliness. Future co-design work could tailor digital peer-delivered interventions to these unmet needs. Intervention preferences and implementation barriers and enablers identified in this study that could guide further co-design and development such interventions.