Kaul Usha, Scher Clara, Henderson Charles R, Kim Patricia, Dyhrberg Mette, Rudin Vanessa, Lytle Millie, Bundy Nicole, Reid M Carrington
Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, United States.
Rutgers School of Social Work, New Brunswick, NJ, United States.
Front Pain Res (Lausanne). 2022 Jul 25;3:921428. doi: 10.3389/fpain.2022.921428. eCollection 2022.
The rapid growth of mobile health (mHealth) devices holds substantial potential for improving care and care outcomes in aging adults with chronic non-cancer pain (CNCP), however, research evaluating these devices in older adults remains limited.
To ascertain the feasibility and preliminary efficacy of an mHealth intervention (Mymee) that combines symptom, diet, and behavior tracking a smartphone application with data analytics to detect associations between symptoms and lifestyle factors along with weekly health coaching sessions to mitigate CNCP in adults 55 years of age and older.
Participants ( = 31) in this pilot study were recruited from one primary care practice in New York City and randomized to an intervention [app + up to 12 health coaching sessions (scheduled approximately once weekly) + usual care] or a control (app + usual care) arm. Feasibility measures included recruitment (proportion of eligible persons who enrolled) and retention rates (proportion of subjects completing a follow-up assessment) as well as adherence with the weekly coaching sessions and logging daily data on the app. Efficacy outcomes (e.g., pain intensity, self-efficacy, disability, anxiety) were assessed at baseline and follow-up (~16 weeks after baseline). Descriptive statistics were obtained and general linear mixed models used for primary analyses.
Participants had a mean (standard deviation) age of 67.32 (9.17) and were mostly female (61%). Feasibility outcomes were mixed as evidenced by recruitment and retention rates of 74% and 65%, respectively. The mean number of weekly coaching sessions attended by intervention participants was 6.05 (SD = 5.35), while the average number of days logging data on the app was 44.82 (34.02). We found a consistent trend in favor of the intervention, where pain intensity, affect, and quality of life measures improved considerably more among intervention (vs. control) participants. Finally, the proportion of participants with GAD-7 scores at follow up decreased by 0.35 to 0, whereas controls did not change, a significant effect in favor of the intervention ( = 0.02).
This study supports the need for future research that seeks to enhance feasibility outcomes and confirm the efficacy of the Mymee intervention among aging adults with CNCP.
移动健康（mHealth）设备的快速发展，为改善患有慢性非癌性疼痛（CNCP）的老年人的护理及护理效果具有巨大潜力，然而，针对老年人使用这些设备的研究仍然有限。
确定一种移动健康干预措施（Mymee）的可行性和初步疗效，该措施结合了症状、饮食和行为追踪——一款智能手机应用程序及数据分析，以检测症状与生活方式因素之间的关联，并通过每周的健康指导课程来缓解55岁及以上成年人的慢性非癌性疼痛。
这项试点研究的参与者（n = 31）从纽约市的一家初级保健机构招募，并随机分为干预组[应用程序+最多12次健康指导课程（大约每周一次）+常规护理]或对照组（应用程序+常规护理）。可行性指标包括招募率（登记的合格人员比例）和保留率（完成随访评估的受试者比例），以及对每周指导课程的依从性和在应用程序上记录每日数据的情况。在基线和随访时（基线后约16周）评估疗效指标（如疼痛强度、自我效能感、残疾、焦虑）。获得描述性统计数据，并使用一般线性混合模型进行主要分析。
参与者的平均（标准差）年龄为67.32（9.17）岁，大多数为女性（61%）。可行性结果喜忧参半，招募率和保留率分别为74%和65%。干预组参与者每周参加指导课程的平均次数为6.05（标准差 = 5.35），而在应用程序上记录数据的平均天数为44.82（34.02）。我们发现了有利于干预的一致趋势，即干预组（与对照组相比）参与者的疼痛强度、情感和生活质量指标改善幅度更大。最后，随访时广泛性焦虑障碍量表（GAD - 7）得分的参与者比例从0.35降至0，而对照组没有变化，这是有利于干预的显著效果（P = 0.02）。
本研究支持未来开展研究，以提高可行性结果，并确认Mymee干预措施对患有慢性非癌性疼痛的老年人的疗效。
