Professional-facing digital health technology for the care of chronic pain patients: A scoping review (Preprint)

Abstract

BACKGROUND Chronic pain is a highly prevalent condition, estimated to be affecting as many as 30% of people worldwide. The need for more innovative solutions for chronic pain management is clear, and Digital Health Technology (DHT) may be the best way to address this challenge. Much of the digital health research focusing on chronic pain focuses on patient-facing solutions, however, DHT for healthcare professionals is equally important to support evidence-based practice, which in turn improves patient outcomes. Despite this, no review has investigated the availability of professional-facing DHT for chronic pain management. OBJECTIVE The overall aim of this scoping review was to identify the available professional-facing DHT for the purpose of chronic pain management. Specifically, the objectives were to investigate the components of the DHTs, the development methods, the user features, the outcomes and HCP perspectives on DHT for chronic pain care. METHODS Databases including Medline, EMBASE, CINAHL, PsycInfo and Inspec were searched using a comprehensive search strategy developed for each specific database alongside an academic librarian. Two independent reviewers screened titles and abstracts for review inclusion, then conducted full-text screening. Any conflicts in each stage of the screening process were first resolved through discussion, then through a third independent reviewer. Data extraction and quality assessment was completed using the TiDIER checklist and QuADS. Qualitative analysis involved inductive content analysis (of user features) and thematic synthesis (of HCP perspectives). RESULTS A total of 52 studies were included in the review, reporting on 44 professional-facing DHT. The included DHT were intended for remote patient monitoring, clinical decision support, assessment and diagnosis, education of HCPs or a combination. The most common target population for DHT use was multidisciplinary care teams; the most common setting for implementation was primary care. Approximately half of the professional-facing DHT had a connected patient-facing system. Inductive content analysis of the user features produced four themes: guiding initial consultation, supporting chronic pain management, facilitating ongoing patient management and supporting routine clinical duties. Thematic synthesis of HCP perspectives produced four themes reflecting factors affecting use of DHT in chronic pain care: additional value, integration into clinical workflow, ease of navigation, and trust in the DHT. Most of the included studies did not adequately report appropriate stakeholder involvement in a proper co-design of DHT; only three of the DHT were reported to have been developed with guidance from a system development framework. CONCLUSIONS There are various DHTs available for HCPs to use in the management of chronic pain. The included studies did not report adequate stakeholder involvement in the DHT development nor any specific frameworks to guide rigorous co-design. Therefore, future research should focus on developing professional-facing DHT with active involvement of stakeholders in the design process. CLINICALTRIAL The protocol for this scoping review is published in JMIR protocols (McCartney et al, 2024). INTERNATIONAL REGISTERED REPORT RR2-10.2196/51311