PAIN+ CPN

Thomson CJ, Pahl H, Giles LV Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain. Can J Pain. 2024 Aug 19;8(1):2352399. doi: 10.1080/24740527.2024.2352399. eCollection 2024. (Original study)
Abstract

BACKGROUND: Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives.

AIMS: Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application.

METHODS: Participants (n = 198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (n = 98) or a wait-listed usual care group (n = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks.

RESULTS: We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, P < .001, d = 0.43) and -0.60 (95% CI -1.18 to -0.03, P = .04, d = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (P < .001) and pain catastrophizing (P = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (P < .05).

CONCLUSIONS: A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.

Ratings
Discipline Area Score
Psychologist 6 / 7
Physician 6 / 7
Show me more articles about:
  Chronic Pain
Comments from MORE raters

Physician rater

The observation period is too short for a problem like chronic pain that may last for years.

Physician rater

These results are expected.

Psychologist rater

Small effect sizes were found for the treatment app, but use of the app over time was associated with a number of positive outcomes. These results suggest an app of this sort could be beneficial for psychotherapy patients between sessions.
Comments from PAIN+ CPN subscribers

Ms. Heather Taylor (9/13/2024 11:55 AM)

This study investigates the effectiveness of using the Curable app in reducing chronic pain and pain interference with life. It showed significant but small improvements in both outcomes. It may help health care professionals in their decision-making in recommending the Curable app. Some design challenges may have limited the effectiveness.