Magee Michael Reece, McNeilage Amy Gray, Avery Nicholas, Glare Paul, Ashton-James Claire Elizabeth
Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, Australia.
JMIR Form Res. 2021 May 18;5(5):e25969. doi: 10.2196/25969.
Patients with chronic pain who are tapering prescription opioids report a need for greater support for coping with symptoms of pain and withdrawal. Mobile health (mHealth) technologies (SMS text messaging- or app-based) have the potential to provide patients with educational, emotional, and motivational support for opioid tapering beyond what is offered by their health care provider. However, it is not known whether patients with chronic pain who are tapering opioids would be willing or able to engage with technology-based support.
This study aims to examine patients' use of mobile technologies in health care, interest in using mHealth support, preferences for the form and content of mHealth support, and potential barriers to and facilitators of engagement with mHealth support for opioid tapering.
A total of 21 patients (11 women and 10 men; age range 29-83 years) with chronic noncancer pain on long-term opioid therapy who had recently initiated a voluntary opioid taper were recruited from primary and tertiary care clinics in metropolitan and regional Australia for a larger study of patients' experiences of opioid tapering. Participants had been taking prescription opioids for a mean duration of 13 (SD 9.6; range 0.25-30) years at the time of the study. Survey items characterized participants' typical mobile phone use and level of interest in mobile technology-based support for opioid tapering. Semistructured interviews further explored patients' use of mobile technologies and their interest in, preferences for, and perspectives on potential barriers to and facilitators of engagement with mHealth support for opioid tapering. Two researchers collaborated to conduct a thematic analysis of the interview data.
All participants reported owning and using a mobile phone, and most (17/21, 81%) participants reported using mobile apps. The majority of participants expressed interest in SMS text messaging-based (17/21, 81%) and app-based (15/21, 71%) support for opioid tapering. Participants expected that messages delivering both informational and socioemotional support would be helpful. Participants expected that access to technology, mobile reception, internet connectivity, vision impairment, and low self-efficacy for using apps may be barriers to user engagement. Patients expected that continuity of care from their health care provider, flexible message dosing, responsivity, and familiarity with pain self-management strategies would increase user engagement.
The results of this study indicate that patients with chronic noncancer pain may be willing to engage with SMS text messaging-based and app-based mHealth interventions to support opioid tapering. However, the feasibility and acceptability of these interventions may depend on how patients' preferences for functionality, content, and design are addressed.
正在逐渐减少处方阿片类药物用量的慢性疼痛患者表示，他们需要在应对疼痛和戒断症状方面获得更多支持。移动健康（mHealth）技术（基于短信或应用程序）有潜力为患者提供超出医疗服务提供者所提供的阿片类药物减量方面的教育、情感和激励支持。然而，尚不清楚正在逐渐减少阿片类药物用量的慢性疼痛患者是否愿意或能够参与基于技术的支持。
本研究旨在调查患者在医疗保健中对移动技术的使用情况、对使用移动健康支持的兴趣、对移动健康支持的形式和内容的偏好，以及参与阿片类药物减量移动健康支持的潜在障碍和促进因素。
从澳大利亚大都市和地区的初级和三级医疗诊所招募了总共21名正在接受长期阿片类药物治疗的慢性非癌性疼痛患者（11名女性和10名男性；年龄范围29 - 83岁），他们最近开始自愿减少阿片类药物用量，以进行一项关于患者阿片类药物减量体验的更大规模研究。在研究时，参与者服用处方阿片类药物的平均时长为13年（标准差9.6；范围0.25 - 30年）。调查项目描述了参与者的典型手机使用情况以及对基于移动技术的阿片类药物减量支持的兴趣水平。半结构化访谈进一步探讨了患者对移动技术的使用情况，以及他们对参与阿片类药物减量移动健康支持的兴趣、偏好、潜在障碍和促进因素的看法。两名研究人员合作对访谈数据进行了主题分析。
所有参与者都报告拥有并使用手机，大多数（17/21，81%）参与者报告使用移动应用程序。大多数参与者表示对基于短信（17/21，81%）和基于应用程序（15/21，71%）的阿片类药物减量支持感兴趣。参与者预计，提供信息和社会情感支持的信息会有所帮助。参与者预计，获取技术、移动信号接收、互联网连接、视力障碍以及使用应用程序的自我效能低可能是用户参与的障碍。患者预计，医疗服务提供者的持续护理、灵活的信息发送频率、响应能力以及对疼痛自我管理策略的熟悉程度会提高用户参与度。
本研究结果表明，慢性非癌性疼痛患者可能愿意参与基于短信和应用程序的移动健康干预，以支持阿片类药物减量。然而，这些干预措施的可行性和可接受性可能取决于如何满足患者对功能、内容和设计的偏好。
