Pain buddy: A novel use of m-health in the management of children's cancer pain

Abstract

Background Over 12,000 children are diagnosed with cancer every year in the United States. In addition to symptoms associated with their disease, children undergoing chemotherapy frequently experience significant pain, which is unfortunately often undertreated. The field of m-Health offers an innovative avenue for pain assessment and intervention in the home setting. The current study describes the development and initial evaluation of a tablet-based program, Pain Buddy, aimed to enhance pain management and foster improved quality of life in children ages 8–18 years undergoing cancer treatment. Methods An animated avatar-based tablet application was developed using state-of-the-art software. Key aspects of Pain Buddy include daily pain and symptom diaries completed by children, remote monitoring of symptoms by uploading patient’s data through internet to a cloud server, cognitive and behavioral skills training, interactive three-dimensional avatars that guide children through the program, and an incentive system to motivate engagement. Twelve children between the ages of 8 and 18 participated in a pilot study of Pain Buddy. Results Children were highly satisfied with the program. Pain and appetite disturbances were most frequently endorsed. Symptom trigger alerts to outside providers were largely related to clinically significant pain. Children infrequently used analgesics, and reported using some non-pharmacological pain management strategies. Conclusion Pain Buddy appears to be a promising tool to improve pain and symptom management in children undergoing cancer treatment. Results from the current study will inform future improvements to Pain Buddy, in preparation for a randomized controlled trial to assess the efficacy of this innovative treatment.

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

“…Some studies suggested that remote monitoring of symptoms empowered patients to participate in their care and better manage their condition due to increased knowledge of their condition and symptom management strategies provided by the mobile interventions [31,[34][35][36]48]. In qualitative interviews with 11 lung and colorectal cancer patients, patients explained that this type of intervention had increased their understanding of their symptom-related problems and consequently, their confidence in their abilities to manage symptoms [36].…”

“…Fortier et al, 2016 [34] Patients were highly satisfied with the app and perceived it to be useful. Pain and appetite disturbances were the most frequently reported symptoms.…”

“…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].…”

“…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.…”

Technologies used to Minimize Oncological Pain in Children and Adolescents: A Literature Review

“…The third article deals with sedation during painful procedures and resulting in decreased suffering during procedures, less physical restraint and amnesia reporting during procedures [10]. The distraction of the child was approached in four articles, the technologies were a therapeutic toy [8], virtual reality [13], drawing on distraction techniques [11] and a tablet program [14]. Three of the technologies were tested during painful procedures.…”