The Influence of Mobile Health Interventions on Aftercare and Medication Use for Patients With Chronic Pain: A Systematic Review

Abstract Objective To evaluate the impact of mobile health interventions (MHI) on opioid use, non-opioid medication use, adherence, quality-adjusted life years (QALYs), and healthcare utilization among adults with chronic pain. Patients and Methods A systematic review (PROSPERO CRD4202457819) was conducted using PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library from April 23, 2024, through May 2, 2025. Randomized controlled trials (RCTs) evaluating mobile-accessible interventions for adults aged 18–65 with chronic pain, low back pain, or chronic low back pain were included. Two reviewers independently screened studies and assessed risk of bias. Due to heterogeneity, outcomes were synthesized narratively, and standardized mean differences were calculated when appropriate. Results Fourteen trials (n = 3766) met inclusion criteria. Six studies (n = 1098) evaluated opioid use, with four reporting significant reductions. All five studies assessing non-opioid medication use (n = 810) demonstrated decreases. Of four studies examining adherence (n = 851), three showed improvement. QALY gains were observed in four of five studies (n = 2252), though effect sizes were small. No significant reductions in healthcare utilization were identified across included trials. Conclusion MHI reduce opioid and non-opioid medication use and improve adherence in adults with chronic pain. Evidence for QALY improvement is modest, and effects on healthcare utilization remain uncertain. MHI serve as valuable adjuncts to chronic pain care, particularly for medication stewardship. Further high-quality, long-term randomized trials using standardized outcome measures are needed.