Tracking Pain: There' s an App for That
Individuals who cope with chronic pain are accustomed to getting a prescription for medication. Now, they may be getting something else from their doctors: a smartphone app meant to help them manage their symptoms and enable real time feedback.
“Recommending apps for pain is becoming increasingly common,” said Josie Znidarsic, DO, who runs the Integrative Pain Program at the Wellness Institute of the Cleveland Clinic. “Everyone has a phone, and these apps offer something valuable that a patient can look at just by pulling out his phone. Any time we can get more information about ourselves and learn ways to practice better self-care, we can improve our health and wellness.”
While it’s difficult to know how many apps currently exist, the number is on the rise, she said. “More apps will definitely be coming out,” Ms. Cowan admitted. “They can be very useful in terms of communicating a lot of information in a very short period to a health care provider.” The newest apps are designed to target specific pain points, such as breakthrough pain related to cancer. Prescribed and overseen by doctors, they typically require the involvement of an individual’s physician to be effective.
With a mobile app, patients may use a digital log to keep track of how much pain they are in at a particular time, as well as what triggers the pain. The health care provider can then look at the pattern to see what might be causing it and evaluate the most effective way to treat it.
The apps not only enable patients to share vital medical information quickly with their physicians, but can also help patients stay on track with their therapy, explained Joseph Kvedar, MD, vice president of Connected Health, at Partners HealthCare in Boston, and the author of The Internet of Healthy Things.
Dr. Kvedar helped to develop a cancer pain management app known as ePal that aims to show patients how to deal with moderate to severe cancer-related pain. The patients who used the ePal in a recent clinical trial could request medication refills, view educational videos, and keep notes on how they were feeling.
“The app also educates cancer patients about their pain,” Dr. Kvedar said. “Some patients think that if it hurts, this means they are fighting the tumor, but that is a myth. Other patients worry about getting addicted to pain medication, and the app explains to them the difference between addiction and increased tolerance.”
The ePal assesses a patient’s pain level based on the input of both doctor and patient, and a dosage of medication is recommended. Three or four hours later, the app checks back in to see if the patient is getting relief or if the medication dosage needs adjusting. A successful clinical trial to test ePal with patients just ended and Dr. Kvedar hopes the app will be available to the public soon. “We want to make sure it is useful to everyone and we want to make sure it works before we put it out there,” he explained.
A Better Way for Hospitals to Keep Doctors Informed About Patient Pain
Hospitals are also getting in on the act and becoming more pro-active about using apps for chronic pain, said Raj Agarwal, CEO and president of Medocity, which makes a mobile app called iCancer Health. “I would say that particularly in the last three months, hospitals have become more interested in the apps,” he said. “It might take some time, but apps to treat chronic pain are a definitive trend.”
Medocity’s iCancerHealth, a free app aimed at both patients and caregivers, manages and tracks medications, symptoms, and a patient’s overall treatment plan, he said. It also offers relevant disease and drug-specific information to a patient’s caregivers, and encourages patients to become more active in managing their own health.
The app, which helps users manage their cancer care at home, has a health tracker that allows patients to chart their own pain. The section on medication reports back to the provider how many doses a patient has taken or missed and when the next dose is due. A clinical trial of iCancerHealth is currently underway at the Dana Farber Institute, Mr. Agarwal said.
Apps that Alleviate Stress Can Diminish Pain, too
Although Dr. Znidarsic does not use apps for chronic pain management, she does recommend apps that focus on mindfulness and stress reduction because she feels stress can exacerbate pain. Her favorites: Stop, Breathe and Think; The Mindfulness App; and Happify.
“Stress absolutely makes chronic pain worse,” Dr. Znidarsic said. “There are physical changes that occur in the body when someone is in a stressful situation and that causes inflammation to increase.” Muscles tighten, stress hormones build up, and pain worsens, she explained. To reduce stress, some mobile apps feature reminders in which a person’s smartphone chimes to signal that it’s time to do some deep breathing or to spend a few minutes focusing on gratitude, Dr. Znidarsic said.
On the ePal app, users who need more pain relief have the option of pushing a button to be connected to a pain medication specialist, Dr. Kvedar explained. But when the app was being tested, patients didn’t push the button very often, he found. “They said the app gave them what they needed,” he said. “And this really was our original intent: to empower patients.”
The new chronic pain apps are not standard of care yet, Dr. Znidarsic said. “The issue of chronic pain is so diverse and multifaceted,” she said. “And it is difficult to treat unless you really consider the whole package: mind, body and spirit. But the accessibility of the new chronic pain apps is making it easier.”