Engagement with a Mobile App for Chronic Pain

Objectives: Mobile health (mHealth) technology has been utilized to offer self-management tools to people with pain, including symptom tracking. Existing mobile tracking applications (apps) for chronic pain management have demonstrated reliability, feasibility, improved coping, and reduced healthcare utilization. Unfortunately, adherence in using a pain app can be problematic with many not using or discontinuing its use early. The current study aimed to investigate the impact that pain self-efficacy, pain conceptualizations, patient perception of pain care providers, has on engagement with a mobile pain tracking app. Methods: Seventy-six (N=76) individuals with chronic pain downloaded a pain app and completed questionnaires assessing their pain and use of a pain app 3 months after they had downloaded the app. Associations with engagement with the app, defined as number of daily diaries completed, and demographic and self-report questionnaire data were examined. Results: Results showed that engagement with the app was unrelated to self-efficacy and pain conceptualization but significantly related to positive perceptions of their pain care providers. Subjects with more severe pain were found to have lower self-efficacy, less understanding of the biopsychosocial model of pain, and lower satisfaction with their involvement in their pain care decisions. Surprisingly, those who engaged more with the app demonstrated lower self-efficacy as compared to those used the pain app less. Discussion: These findings highlight the importance of the patient-provider relationship in engaging with mHealth technology for pain management. Results further imply that longer-term use of mHealth tools may not be perceived as adaptive or clinically helpful for certain individuals.