Self-management of arthritic pain for older people in the community: Do Apps have a role to play?

A blog post written by Priyanka Bhattarai, Research Associate, ELDAC (End-of-Life Directions for Aged Care)

Unrelieved pain is one of the most common health conditions affecting the majority of older people. Significant proportion of older Australian experience chronic pain, while also living with multiple life-limiting illnesses. As many older people live in the community, self-management strategies are central to improve their unrelieved chronic pain and minimise the adverse impact of pain on their lives. While structured pain self-management programs have traditionally been grounded in face-to-face coaching approaches, there has been a growing interest in the use of technology mediated self-management intervention to promote and support self-management.

Significant advances in smartphone technology and a proliferation of applications (‘Apps’) development has occurred since the release of the first Apple iPhone in 2007. Advanced computing features of mobile devices (i.e. smartphones and tablet-computers) provides opportunities to improve health outcomes by empowering users to assume a more active role in monitoring and managing their own health. Scalability combined with the friendly user-interface has led to the rapid proliferation of Apps, with well over 300,000 health and fitness Apps currently available for download across various platforms. Estimates suggest that this market will be worth over USD 111 Billion by the year 2025.

Technological advances are enabling the integration of mobile healthcare Apps into the self-management plans for people living with various chronic and complex conditions, including pain. There are currently hundreds of pain self-management Apps providing features such as: pain assessment recording, pain related information, and pain self-management plans. Concurrently, the last decade has also seen an overwhelming interest from the research community in testing this new and interesting modality for assessment and self-management of pain. However, much of the studies carried out in this field exclusively include younger participants, leaving behind the older population which carries a disproportionate burden on chronic and arthritic pain symptoms. Little is known about the feasibility and impact of Apps on older people’s pain self-management regimes

As older people with chronic pain indicate willingness to learn and use smartphones and Apps for pain self-management, the feasibility, acceptability and effectiveness of using a pain App to help older people better self-manage their arthritic pain warrants further investigation.

To contribute towards closing the knowledge gap in this area, a team of researchers are carrying out a study to investigate if pain self-management Apps are a feasible and acceptable modality to assist older people to better manage their arthritic pain. This project titled ‘Using Digital health technology to optimise older people’s pain self-management capabilities’ or DigiTech-Pain Project in short, forms a significant part of Ms. Priyanka Bhattarai’s Doctoral studies, which she is undertaking at the University of Notre Dame, under the supervision on Prof Jane Phillips and A/Prof Toby Newton-John.

By asking older people living with arthritic pain in the community to use a publicly available pain self-management App for two weeks, this project will report on the impact of such App use on participants’ pain and self-efficacy outcomes. In addition, older people’s experience and perceptions on App use will be captured via in-depth interviews. As primary and allied health clinicians play an important role in older people’s pain self-management process, this project is also conducting interviews with clinicians to capture their views about integration of Apps into older people’s pain self-management strategies. By integrating data from all of the components of this project, the research team intends to understand if it is worth considering the use of Apps in the area of pain management.

The findings of this study also have implications for future research and practice in the aged and palliative care sectors. Almost 90% of older Australians report having one or more chronic health conditions including life-limiting conditions such as advanced heart, kidney and lung disease, App-based self-management approaches have potential to help these individuals better manage these conditions. Furthermore, integration of apps could facilitate tele-monitoring of older people which could be a helpful alternative for those unable to access community palliative care support. As the aging population continues to engage with smartphone technologies, further exploration of this modality to support end-of-life healthcare needs is warranted.

For more information regarding this project, email Ms. Priyanka Bhattarai priyanka.bhattrarai1@my.nd.edu.au

Priyanka Bhattarai, Research Associate, ELDAC (End-of-Life Directions for Aged Care)

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