Follow up of patients with chronic pain using an app with a support center: unicenter prospective study (Preprint)

BACKGROUND Lower back pain is one of the most prevalent diseases, and should be treated with a multidisciplinary approach, being a possibility the use of spinal cord stimulation. These patients need a close follow up that cannot always be guaranteed, with new technologies helping in that regard. We designed a remote follow up system based on a mobile phone app for the patient, a web for professionals, and a remote support center. OBJECTIVE To evaluate patient adherence to follow up using a system with phone app and a remote support center. METHODS After reviewing the literature and approval in a multidisciplinary committee, a group of experts designed a follow up system based on a mobile phone app, a web for professionals and a remote support center. The system was designed with medical professionals involved, sending validated scales to obtain patients’ clinical information through every phase of the implantation (pre-treatment phase, trial phase and implantation phase). Data was collected prospectively from annuary 2020 to august 2023, considering total surveys sent and surveys answered to, in addition to reminders sent. RESULTS A total of 64 patients were included (40 female, 62’5%). At the end of the study, 19 patients were in the pre-treatment phase (29’7%), 8 patients achieved the trial phase (12’5%) and 37 achieved the implantation phase (57’8%). The follow up time was 15’30 +/- 9’43 months (mean +/- SD). A total of 1574 surveys were sent, with a total of 488 sms and 53 calls to remind the patients to answer the surveys. Adherence rates decreased from 94’53% in pre-treatment phase to 65’68% in implantation phase, being the global adherence to the use of the app 87’37%. In the ANOVA analysis, the adherence was proved better the earlier phase the patient was in (p>0’001). CONCLUSIONS Our remote follow up system with a remote support center provides better adherence to follow up, even if the adherence tends to decrease over time. More studies are needed to correlate app adherence with pain control.