BACKGROUND: Chronic pain is often accompanied by significant functional disability. Since people with chronic pain often experience a decrease in resilience -as a key psychological factor that significantly impacts pain intensity and disability level - the present study aimed to determine the effect of enhancing pain resilience through a smartphone-based application on pain intensity, and disability in this population.
METHODS: In the present randomized controlled trial, 108 patients with chronic pain were randomly assigned to three groups. Control group (A) received routine care, and control group (B) received short text-message-based educational content regarding chronic pain and its influencing factors. The intervention group patients also used the content of the enhancing resilience against chronic pain application for 8 weeks. The participants' outcomes including pain intensity and disability, were evaluated before, immediately after, and three months after the intervention. To examine the between-group differences in the mean outcome scores, ANOVA and Kruskal-Wallis tests were used. To examine the within-group differences in the mean outcome scores, repeated-measures and Friedman tests were used.
RESULTS: The study results showed a significant difference in the mean pain intensity, and disability scores between the intervention group and control groups immediately and three months after the intervention (P=0.001). The mean pain intensity score and disability score were lower in the intervention group compared to the control groups. The mean pain intensity and disability scores showed significant decreases in the intervention group from before the intervention to immediately and three months after (P=0.001).
CONCLUSION: The results confirmed the positive effects of the smartphone-based "Enhancing Resilience Against Chronic pain" application on pain intensity, and disability in chronic noncancer pain patients. Given mobile phone accessibility, researchers recommend that healthcare providers, especially nurses, use virtual education to reduce pain and disability in chronic pain patients.
TRIAL REGISTRATION: Number: IRCT20210719051944N1, URL: https://www.irct.ir/trial/57624, date: 31/10/2021.
| Discipline Area | Score |
|---|---|
| Rehab Clinician (OT/PT) |  |
| Physician |  |
Physician rater
In patients with chronic non-cancer pain, a resilience app reduced pain and disability. However, resilience was not measured; patients knew which group they were in; outcomes were self-reported; reporting of dropouts was unclear; and follow-up lasted only three months. The findings need to be replicated using objective measures of function, resilience scores, and longer follow-up.
Physician rater
The findings should be interpreted with considerable caution. The main methodological limitations were the use of a control group that received substantially less therapeutic attention than the intervention group, increasing the risk of expectation and attention bias. In addition, the inclusion of a clinically heterogeneous sample reduces the precision of the estimated effects and limits the generalisability.
Physician rater
The findings should be interpreted with considerable caution. The main methodological limitations were the use of a control group that received substantially less therapeutic attention than the intervention group, increasing the risk of expectation and attention bias. The inclusion of a clinically heterogeneous sample reduces the precision of the estimated effects and limits the generalisability.
Physician rater
The trial did not report drug use or adverse events. Pain type was not analysed separately. Outcomes were self-reported, patients were unblinded, and the control group did not receive matched contact time. Larger trials should test whether the intervention reduces drug use, which patients benefit, and how long the effects last, by pain type.
Rehab Clinician (OT/PT) rater
This randomised trial does not present between-group differences.
, McMaster University