Practical Apps 9: Chronic Pain (Revisited)

author

Dr. Stephen Pomedli
Toronto, Ontario
@pomedli

Bio

Dr. Stephen Pomedli is a family physician and the co-founder of ConsultLoop, an online referral platform that helps connect family doctors with specialists and betters the referral process for patients. He studied medicine at Harvard Medical School and completed a Master’s in International Health Policy at the London School of Economics. After his residency at St. Michael’s Hospital, he undertook a Global Health fellowship at the University of Toronto, looking at best practices in family medicine in Canada, the United States and Brazil. As a previous Innovation Fellow at Women’s College Hospital, he worked with a group of clinicians, entrepreneurs, designers and policy-makers to find new approaches to designing healthcare services, especially for patients with complex health care needs.

Apps Reviewed:

What Experts Say

Watch our interview with chronic pain consultant, and medical director, Dr. Jackie Gardner-Nix about chronic pain.

Patient Experiences

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Pain Coach

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Pain Coach is part of WebMD’s suite of online health information. It probably has the best and deepest resources for providing educational materials and tips for the self-management of pain – though the pain tracking and goal setting modules are less well-developed. The majority of the informational articles name the physician or health professional who reviewed that specific section, which lends credibility. However, the app also functions as a portal to WebMD’s main site via the app, which seems less rigorously reviewed and sometimes cites less reliable sources, not to mention that the website is rife with ads for health products and services. Any user of this app should be aware of this advertising slant and that their data may be used for marketing purposes, as cited in the privacy policy.

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CatchMyPain

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The stand-out feature of CatchMyPain is the discussion forum and community, which provide tips from fellow chronic-pain-trackers, as well as support, validation, and often, camaraderie. Importantly, these forums seem to be quite active and well-moderated to keep comments on topic, respectful, and relevant. The pain tracking features are quite basic with reports that are likely a bit too simplistic, and there is no vetted information to support self-management. As this app was developed in partnership with pharmaceutical companies, certain profile information seems to be collected solely for the use of these groups and less so for the users’ benefit. It is important that patients be aware of how their data will be used by these third parties.

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Manage My Pain

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Manage My Pain is designed to “track, analyze and share” pain symptoms, and does this admirably, producing clean and useful reports to communicate with medical professionals, without unnecessary bells and whistles. A new functionality uses a Daily Reflection to track “Meaningful Activities”. This helps go beyond just pain reporting and logs whether or not the user is still able to engage in meaningful activities, the ultimate goal of chronic pain management often overlooked by other tracking apps [5]. The app doesn’t provide any supports for self-management or educational information related to specific pain syndromes.

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Chronic Pain Tracker

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Along with the usual tracking features, such as daily reminders and symptom customizability, this pain tracking app has 19 different “modules” that track everything from fatigue levels and sleep quality to weather patterns. This breadth attempts to address the complexity of chronic pain, though some modules are definitely not as rigorous as others. Chronic Pain Tracker also encourages the use of multiple simultaneous “Pain Diaries” to track the elements and trajectories of different types of pain, for example, tracking migraines and knee pain at the same time. The reports are very detailed and a definite strength of this app, and could be very useful in sharing information with providers. The major drawbacks relate to the busy interface and the lack of any privacy policy.

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My Pain Diary

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A straightforward pain tracking app with a very narrow feature set, but the features seem to generally work quite well. The app only has a few truly unique features – such as creating customized push notifications, including photos with entries, keeping certain diary entries private, and choosing to include or exclude them from reports or graphs – which are not huge differentiators. While My Pain Diary tries to make associations and correlations between symptoms and other trends, including affective state and weather patterns, it falls short by not having more advanced medication tracking options or ways to log the other treatments, life events, or stressors that often affect chronic pain. While the app isn’t intended to provide pain-specific support or knowledge, it misses key opportunities to educate and encourage self-management.

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References:

  1. Moulin et al. Pharmacological management of chronic neuropathic pain: Revised consensus statement from the Canadian Pain Society. Pain Res Manag 2015;19(6):328-335.
  2. Kahan et al. Canadian guideline for safe and effective use of opioids for chronic noncancer pain. CFP 2011;57:1257-66.
  3. Stinson et al. iCanCope with Pain: User-centred design of a web- and mobile-based self-management program for youth with chronic pain based on identified health care needs. Pain Res Manag 2014;19(5):257-265.
  4. Lalloo et al. “There’s a Pain App for That” Clin J Pain 2015;31:557-563.
  5. Rini et al. Meeting them where they are: Using the INternet to deliver behavioral medicine interventions for pain. TBM 2012;2;82-92.

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