Initial Testing of a Mobile App Pain Coping Intervention for Outpatient Oncology Settings

针对门诊肿瘤科设置的移动应用程序疼痛应对干预的初步测试

• 批准号: 10647280
• 负责人: Sarah Kelleher
• 金额: $ 22.58万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-17 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10647280
• 关键词: Adherence; Aftercare; Appointment; Appointments and Schedules; Behavior Therapy; Behavioral; Businesses; Cancer Pain Management; Cancer Patient; Cellular Phone; Clinical Oncology; Cognitive; Cognitive Therapy; Coping Skills; Data; Distress; Electronic Mail; Electronics; Emotional; Funding; Future; Goals; Home; Hour; Intervention; Learning; Link; Malignant Neoplasms; Medical Records; Medical center; Mission; Modeling; Oncology; Outcome; Outpatients; Pain; Pain Measurement; Pain interference; Pain management; Participant; Patient Preferences; Patients; Persons; Protocols documentation; Provider; Public Health; Publishing; Quality of life; Randomized; Randomized, Controlled Trials; Recommendation; Relaxation; Reporting; Research; Resource-limited setting; Resources; Self Efficacy; Severities; Specialist; Symptoms; System; Tablets; Technology; Testing; Text; Time; Training; Translating; United States National Institutes of Health; Update; Videoconferencing; Work; cancer care; cancer pain; clinical pain; clinical practice; comparison intervention; coping; cost; daily pain; design; disability; effectiveness clinical trial; effectiveness testing; efficacious intervention; experience; flexibility; implementation strategy; improved; innovation; mobile application; mobile computing; programs; satisfaction; theories; videoconference

Pain is a common and distressing symptom for cancer patients. There is strong evidence that behavioral pain interventions – a non-pharmacological approach to pain management – are efficacious for decreasing pain. Yet, these interventions are not currently widely available to cancer patients due to a number of system, provider, and patient access barriers. Efficacious behavioral pain interventions that are technology-based (vs. face to face) have the potential to decrease access barriers and dramatically improve reach. A standalone mobile app would eliminate the need for a therapist, be available to the patient at all times, and be easily accessible on a personal smartphone or tablet. Mobile apps also offer increased options for real-time personalization (e.g., messaging based on daily pain assessment), which can increase engagement and improve overall outcomes. We have developed a mobile application – PainPac – that has been used as an adjunct to in person and videoconferencing interventions. We have not yet examined PainPac as a standalone intervention. PainPac is an innovative mobile app program that provides patients with coping skills modules of efficacious cognitive-behavioral theory-based pain management strategies. PainPac can be implemented through automated, electronic submission to patients via text, email, and/or MyChart (patient facing medical record) based on a clinical pain report (> 4/10) at a clinical oncology appointment. Our long-term goal is to use mobile app technologies to facilitate widespread implementation of efficacious behavioral cancer pain interventions. The overall objective of this application, which is the next step toward attainment of our long-term goal, is to demonstrate that a mobile app intervention, compared to standard videoconferencing sessions, is feasible (primary aim) and a promising strategy to decrease pain in patients with cancer. Our central hypothesis is our standalone mobile app behavioral cancer pain intervention (PainPac) will demonstrate high feasibility, as well as low patient burden, high engagement, and high acceptability that is at least comparable to a videoconferencing protocol (PCST-Video). We will use a randomized controlled trial to test three aims. The first aim is to test whether PainPac is feasible (primary aim), as well as low burden, engaging, and acceptable to cancer patients. The second aim is to examine the impact of PainPac on pain severity and interference, pain disability, pain self-efficacy, and quality of life. The third aim is to gather qualitative post-treatment data on cancer patients’ preferences, barriers, and facilitators regarding PainPac to optimize PainPac for a future large randomized clinical effectiveness trial. This work has the potential to create a paradigm shift for behavioral pain intervention practice. If PainPac is feasible and beneficial for helping cancer patients learn to manage their pain, the mobile app is poised to be widely disseminated ultimately decreasing pain and suffering for patients with cancer.

疼痛是癌症患者常见且令人痛苦的症状。有强有力的证据表明，行为疼痛 干预--一种非药理学的疼痛管理方法--对减轻疼痛是有效的。然而， 由于许多系统、提供者 和病人接触障碍。有效的基于技术的行为疼痛干预(与面对面相比) 有可能减少访问障碍并显著提高覆盖范围。独立的移动应用程序将 消除了对治疗师的需求，患者可以随时获得帮助，并且可以轻松地通过个人 智能手机或平板电脑。移动应用程序还提供了更多的实时个性化选项(例如消息传递 基于日常疼痛评估)，这可以增加参与度并改善总体结果。我们有 开发了一款名为PainPac的移动应用程序，作为面对面会议和视频会议的辅助工具 干预措施。我们还没有将PainPac作为一项独立的干预措施进行研究。PainPac是一款创新的手机 APP程序，为患者提供基于有效认知-行为理论的应对技能模块 疼痛管理策略。PainPac可以通过自动电子提交给患者来实施 通过文本、电子邮件和/或MyChart(面向病历的患者)基于诊所的临床疼痛报告(&gt；4/10) 肿瘤科预约。我们的长期目标是利用移动应用程序技术促进广泛的 实施有效的癌症疼痛行为干预。此应用程序的总体目标是， 这是实现我们长期目标的下一步，是证明移动应用程序的干预， 与标准视频会议相比，是可行的(主要目标)，也是一种很有前途的战略 减轻癌症患者的疼痛。我们的中心假设是我们的独立移动应用程序行为癌症 疼痛干预(PainPac)将展示高可行性，以及低患者负担、高参与度、 以及至少可与视频会议协议(PCST-Video)相媲美的高可接受性。我们将使用 随机对照试验，检验三个目标。第一个目标是测试PainPac是否可行(主要目标)， 以及低负担，吸引人，并为癌症患者所接受。第二个目标是检查其影响 PainPac对疼痛严重程度和干预、疼痛残疾、疼痛自我效能感和生活质量的影响。第三个目标 是收集关于癌症患者的偏好、障碍和促进者在治疗后的定性数据 PainPac将为未来的大型随机临床疗效试验优化PainPac。这项工作有潜力 为行为疼痛干预实践创造一种范式转变。如果PainPac是可行的和有益的帮助 癌症患者学会管理他们的疼痛，这款移动应用程序最终将被广泛传播 减轻癌症患者的痛苦和痛苦。