scholarly journals Toward Gamified Pain Management Apps: Mobile Application Rating Scale–Based Quality Assessment of Pain-Mentor’s First Prototype Through an Expert Study

10.2196/13170 ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. e13170
Author(s):  
Alexandra Hoffmann ◽  
Corinna A Faust-Christmann ◽  
Gregor Zolynski ◽  
Gabriele Bleser
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Mobile Application ◽  
Rating Scale ◽  
Pain Treatment ◽  
Semistructured Interview ◽  
Content Quality ◽  
Management Techniques ◽  
Health Experts

Background The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. Objective To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. Methods A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. Results The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. Conclusions The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor.

scholarly journals Toward Gamified Pain Management Apps: Mobile Application Rating Scale–Based Quality Assessment of Pain-Mentor’s First Prototype Through an Expert Study (Preprint)

2018 ◽  
Author(s):  
Alexandra Hoffmann ◽  
Corinna A Faust-Christmann ◽  
Gregor Zolynski ◽  
Gabriele Bleser
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Mobile Application ◽  
Rating Scale ◽  
Pain Treatment ◽  
Semistructured Interview ◽  
Content Quality ◽  
Management Techniques ◽  
Health Experts

BACKGROUND The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. OBJECTIVE To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. METHODS A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. RESULTS The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. CONCLUSIONS The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor. CLINICALTRIAL

QIM19-116: Barriers and Trends in Cancer Patients’ referrals to Pain Management in Qatar: A Randomized Cohort Prospective Study

2019 ◽  
Vol 17 (3.5) ◽  
pp. QIM19-116
Author(s):  
Rehab Abdelwahab ◽  
Anas Hamad ◽  
Shereen El Azzaz ◽  
Randa Al Okka ◽  
Mohd A. Wahid ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Pain Clinic ◽  
List Type ◽  
Patients With Cancer ◽  
Referral Criteria ◽  
Management Techniques ◽  
Primary Physicians

Background: Studies showed that 40%–50% of patients with cancer pain receive insufficient analgesia due to different factors (Beyeler et al, Support Care Cancer 2008; Salminen et al, Support Cancer Care 2008), beside the challenges to accurately assess pain, which might affect drug selection and pain control (Stewart, Ulster Med J 2014). In NCCCR, the treating primary physicians (PP) may prescribe analgesics to their patients or refer them to the Pain Management Team (PMT), based on evaluation or as requested by patients. This study will address the clinical concerns of PP, which may lead to refer the patients to PMT, moreover the clinical judgement of PMT on the referred cases whether they need to be refereed or not. Objectives: To determine the efficiency of the referral pathway to the pain clinic by PMT. Methods: PMT is going to assess the referred patient to their clinics according to pain assessment methods. Patients will be evaluated whether they have been appropriately referred or not, any unnecessary referral will be documented based on the following;• If the patient was referred by hematologist or oncologist• If the patient required specialized treatment• If the patient required urgent treatment/prescription or advanced pain management techniques• If the patient required further consultation by pain management• If the patient could be managed by PP Results: 195 patients were newly referred to the pain clinic during the period from March 8, 2018 to August 31, 2018. 12% (23/195) were deemed as unnecessary referrals based on PMT assessment; 43% (10/23) of them were hematology patients, while 57% (13/23) were oncology. The majority was for breast cancer and sickle cell disease patients with 35% for each. According to the PMT assessment, 61% (14/23) patients (95% CI, 40.79%–77.84%) considered unnecessary referrals due to improper basic pain assessment and management by PP, while 30% (7/23) patients (95%CI, 15.60%–50.87%) asked for refill medications. Conclusion: There is 12% unnecessary referrals to PMT, which need further improvement in the referral pathway, via the development of a definite referral criteria to PMT. PP should be encouraged to provide basic pain treatment and to consider multidisciplinary management with appropriate coordination for better improvements in patients’ quality of life.

Psychometric evaluation of the Mobile Application Rating Scale (MARS) (Preprint)

2020 ◽  
Author(s):  
Yannik Terhorst ◽  
Paula Philippi ◽  
Lasse Sander ◽  
Dana Schultchen ◽  
Sarah Paganini ◽  
...  
Keyword(s):  
Health Care ◽  
Construct Validity ◽  
Mobile Application ◽  
Concurrent Validity ◽  
Rating Scale ◽  
Psychometric Evaluation ◽  
Confirmatory Factor ◽  
Health Domains ◽  
Psychometric Quality

BACKGROUND Mobile health apps (MHA) have the potential to improve health care. The commercial MHA market is rapidly growing, but the content and quality of available MHA are unknown. Consequently, instruments of high psychometric quality for the assessment of the quality and content of MHA are highly needed. The Mobile Application Rating Scale (MARS) is one of the most widely used tools to evaluate the quality of MHA in various health domains. Only few validation studies investigating its psychometric quality exist with selected samples of MHAs. No study has evaluated the construct validity of the MARS and concurrent validity to other instruments. OBJECTIVE This study evaluates the construct validity, concurrent validity, reliability, and objectivity, of the MARS. METHODS MARS scoring data was pooled from 15 international app quality reviews to evaluate the psychometric properties of the MARS. The MARS measures app quality across four dimensions: engagement, functionality, aesthetics and information quality. App quality is determined for each dimension and overall. Construct validity was evaluated by assessing related competing confirmatory models that were explored by confirmatory factor analysis (CFA). A combination of non-centrality (RMSEA), incremental (CFI, TLI) and residual (SRMR) fit indices was used to evaluate the goodness of fit. As a measure of concurrent validity, the correlations between the MARS and 1) another quality assessment tool called ENLIGHT, and 2) user star-rating extracted from app stores were investigated. Reliability was determined using Omega. Objectivity was assessed in terms of intra-class correlation. RESULTS In total, MARS ratings from 1,299 MHA covering 15 different health domains were pooled for the analysis. Confirmatory factor analysis confirmed a bifactor model with a general quality factor and an additional factor for each subdimension (RMSEA=0.074, TLI=0.922, CFI=0.940, SRMR=0.059). Reliability was good to excellent (Omega 0.79 to 0.93). Objectivity was high (ICC=0.82). The overall MARS rating was positively associated with ENLIGHT (r=0.91, P<0.01) and user-ratings (r=0.14, P<0.01). CONCLUSIONS he psychometric evaluation of the MARS demonstrated its suitability for the quality assessment of MHAs. As such, the MARS could be used to make the quality of MHA transparent to health care stakeholders and patients. Future studies could extend the present findings by investigating the re-test reliability and predictive validity of the MARS.

scholarly journals Sublingual Buprenorphine/Naloxone and Multi-Modal Management for High-Risk Chronic Pain Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 973
Author(s):  
Shane Kaski ◽  
Patrick Marshalek ◽  
Jeremy Herschler ◽  
Sijin Wen ◽  
Wanhong Zheng
Keyword(s):  
Chronic Pain ◽  
High Risk ◽  
Pain Score ◽  
Rating Scale ◽  
Pain Treatment ◽  
Pain Clinic ◽  
Sublingual Buprenorphine ◽  
Significant Downward Trend ◽  
Chronic Pain Patients ◽  
Pain Patients

Patients with chronic pain managed with opioid medications are at high risk for opioid overuse or misuse. West Virginia University (WVU) established a High-Risk Pain Clinic to use sublingual buprenorphine/naloxone (bup/nal) plus a multimodal approach to help chronic pain patients with history of Substance Use Disorder (SUD) or aberrant drug-related behavior. The objective of this study was to report overall retention rates and indicators of efficacy in pain control from approximately six years of High-Risk Pain Clinic data. A retrospective chart review was conducted for a total of 78 patients who enrolled in the High-Risk Pain Clinic between 2014 and 2020. Data gathered include psychiatric diagnoses, prescribed medications, pain score, buprenorphine/naloxone dosing, time in clinic, and reason for dismissal. A linear mixed effects model was used to assess the pain score from the Defense and Veterans Pain Rating Scale (DVPRS) and daily bup/nal dose across time. The overall retention of the High-Risk Pain Clinic was 41%. The mean pain score demonstrated a significant downward trend across treatment time (p < 0.001), while the opposite trend was seen with buprenorphine dose (p < 0.001). With the benefit of six years of observation, this study supports buprenorphine/naloxone as a safe and efficacious component of comprehensive chronic pain treatment in patients with SUD or high-risk of opioid overuse or misuse.

An Analysis of Apps with a Medication List Functionality for Older People with Heart Failure: Evaluation using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics Functionality Score (Preprint)

2021 ◽  
Author(s):  
Yohanca Maria Diaz-Skeete ◽  
David McQuaid ◽  
Adewale Samuel Akinosun ◽  
Idongesit Ekerete ◽  
Natacha Carragher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Rating Scale ◽  
Scientific Evidence ◽  
Medication List ◽  
Healthcare Informatics ◽  
Medication History ◽  
Clinic Efficiency ◽  
Google Play

BACKGROUND Managing the care of older patients with heart failure (HF) largely centres on medication management. Due to their frequent medication or dosing changes, an app supporting them to keep an up-to-date list of medication could be advantageous. During COVID-19 times, HF outpatients’ consultations are taking place virtually or by phone. An app with the capability to share the medication list with healthcare professionals before consultation could support the clinic efficiency, for example, reducing consultation time. However, the influence of apps on maintaining an up to date medication history for older adults with HF in Ireland remains largely unexplored. OBJECTIVE The objectives of this review are twofold: to review apps with a medication list functionality and to evaluate the quality of the apps included in the review using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality scale. METHODS A systematic search of apps was conducted in June 2019 using the Google Play StoreTM and iTunes App StoreTM. The MARS was used independently by four researchers to assess the quality of the apps using an Android phone and an iPad. Apps were also evaluated using the IMS Institute for Healthcare Informatics functionality score. RESULTS Google play and iOS app stores searches identified 483 potential apps (292 from Android stores and 191 from Apple stores). Six apps met the inclusion criteria. Medisafe app had the highest overall MARS score (4/5) and the medication list & medical records app had the lowest overall score (2.5/5). Five out of the six apps achieved an acceptable quality MARS score (>3.0). Two apps scored the maximum number of features (n=11) according to the IMS Institute for Healthcare Informatics functionality score and two scored the lowest (n=5). The apps had on average 8 functions based on the IMS functionality criteria (range 5 to 11). CONCLUSIONS The quality of current apps with a medication list functionality varies regarding their technical aspects. Most of the apps reviewed have an acceptable MARS objective quality. However, the subjective quality or satisfaction with the apps was poor. Only three apps are based on scientific evidence and have been previously tested. Two apps featured all the IMS Institute for Healthcare Informatics functionalities and half do not provide clear instructions on how to enter medication data, do not display vital parameters data in an easy to understand format and do not guide users on how or when to take their medication. CLINICALTRIAL N/A

scholarly journals Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Mobile Application ◽  
Rating Scale ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

scholarly journals Reassessment of Evidence Synthesis of Occupational Medicine Practice Guidelines for Interventional Pain Management

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 393-482
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Strong Evidence ◽  
Guideline Development ◽  
Medial Branch ◽  
Low Back ◽  
Quality Of Evidence ◽  
Interventional Techniques ◽  
Interventional Pain Management

Background: Appropriately developed practice guidelines present statements of best practice based on a thorough evaluation of the evidence from published studies on the outcomes of treatments, which include the application of multiple methods for collecting and evaluating evidence for a wide range of clinical interventions and disciplines. However, the guidelines are neither infallible, nor a substitute for clinical judgment. While the guideline development process is a complex phenomenon, conflict of interest in guideline development and inappropriate methodologies must be avoided. It has been alleged that the guidelines by the American College of Occupational and Environmental Medicine (ACOEM) prevent injured workers from receiving the majority of medically necessary and appropriate interventional pain management services. An independent critical appraisal of both chapters of the ACOEM guidelines showed startling findings with a conclusion that these guidelines may not be applied in patient care as they scored below 30% in the majority of evaluations utilizing multiple standardized criteria. Objective: To reassess the evidence synthesis for the ACOEM guidelines for the low back pain and chronic pain chapters utilizing an expanded methodology, which includes the criteria included in the ACOEM guidelines with the addition of omitted literature and application of appropriate criteria. Methods: For reassessment, randomized trials were utilized as it was in the preparation of the guidelines. In this process, quality of evidence was assessed and recommendations were made based on grading recommendations of Guyatt et al. The level of evidence was determined utilizing the quality of evidence criteria developed by the U.S. Preventive Services Task Force (USPSTF), as well as the outdated quality of evidence criteria utilized by ACOEM in the guideline preparation. Methodologic quality of each individual article was assessed utilizing the Agency for Healthcare Research and Quality (AHRQ) methodologic assessment criteria for diagnostic interventions and Cochrane methodologic quality assessment criteria for therapeutic interventions. Results: The results of reassessment are vastly different from the conclusions derived by the ACOEM guidelines. The differences in strength of rating for the diagnosis of discogenic pain by provocation discography and facet joint pain by diagnostic facet joint nerve blocks is established with strong evidence. Therapeutic cervical and lumbar medial branch blocks and radiofrequency neurolysis, therapeutic thoracic medial branch blocks, cervical interlaminar epidural steroid injections, caudal epidural steroid injections, lumbar transforaminal epidural injections, percutaneous and endoscopic adhesiolysis, and spinal cord stimulation qualified for moderate to strong evidence. Additional insight is also provided for evidence rating for intradiscal electrothermal therapy (IDET), automated percutaneous disc decompression, and intrathecal implantables. Conclusion: The reassessment and reevaluation of the low back and chronic pain chapters of the ACOEM guidelines present results that are vastly different from the published and proposed guidelines. Contrary to ACOEM’s conclusions of insufficient evidence for most interventional techniques, the results illustrate moderate to strong evidence for most diagnostic and therapeutic interventional techniques. Key words: Guidelines, evidence-based medicine, systematic reviews, ACOEM, interventional pain management, interventional techniques, guideline development, workers’ compensation, chronic pain guidelines, low back pain guidelines

Obstructive sleep apnea is common in patients with high-impact chronic pain – an exploratory study from an interdisciplinary pain center

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Dennis Boye Larsen ◽  
Laila Bendix ◽  
Karin Abeler ◽  
Kristian Kjær Petersen ◽  
Michael Sprehn ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Utility ◽  
Pain Treatment ◽  
Objective Assessment ◽  
High Impact ◽  
Sleep Monitoring ◽  
Predictive Values ◽  
Clinical Pain ◽  
Obstructive Sleep

Abstract Objectives Sleep disturbances are increasingly recognized as a major part of chronic pain pathology. Obstructive sleep apnea (OSA) is a common occurrence in patients with chronic pain attending specialized pain clinics, yet its prevalence remains unclear. Using screening tools such as the Berlin and STOP-BANG questionnaires may aid in early identification of OSA and improve clinical care. This study i) examined the frequency of OSA based on objective sleep monitoring in patients with high-impact chronic pain, ii) explored potential differences in self-reported pain and sleep characteristics between patients with and without OSA, and iii) tested the agreement between OSA classification based on objective assessment and two OSA screening questionnaires. Methods A consecutive cohort of 90 patients (71 women and 19 men; mean age: 47.1 ± 11.0 years) referred for interdisciplinary pain treatment, underwent one night of sleep monitoring using portable respiratory polygraphy (RP), and suspected OSA was confirmed with polysomnography (PSG). Self-reported data on clinical pain (severity, pain drawings and health-related quality of life), sleep characteristics (sleep quality insomnia, sleepiness), and risk of OSA (Berlin and STOP-BANG questionnaires) were collected the day before RP assessment. Results Forty-six (51.1%) patients were classified with OSA according to RP and verified with PSG. Twenty-eight patients (31.1%) had moderate or severe OSA (apnea-hypopnea index [AHI] >15). Patients with OSA reported lower sleep quality compared with patients without OSA. Scores on pain severity, disability, quality of life, insomnia and sleepiness were comparable between patients with and without OSA. Sensitivity and specificity were 78.6 and 45.2% respectively for the Berlin questionnaire, and 71.4 and 58.1% respectively for the STOP-BANG questionnaire. The agreement for both questionnaires with objective assessment was poor-to-fair. Both questionnaires had acceptable negative predictive values but low positive predictive values reducing the clinical utility to identify patients with low OSA-risk in this sample. Conclusions The current study demonstrates a high prevalence of OSA in patients with high-impact chronic pain referred to specialized pain treatment, however the clinical pain profiles were similar in patients with and without OSA. The Berlin and STOP-BANG questionnaires have poor specificity and low-to-fair agreement with RP/PSG questioning their clinical utility in identifying OSA in this sample.

Interventional pain management techniques for chronic pain

2013 ◽  
pp. 474-485
Author(s):  
Navil F. Sethna ◽  
Pradeep Dinakar ◽  
Karen R. Boretsky
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Case Series ◽  
Pain Syndrome ◽  
Treatment Modalities ◽  
Neuraxial Blockade ◽  
Paediatric Case ◽  
Injection Techniques ◽  
Interventional Pain Management ◽  
Management Techniques

As part of multidisciplinary management of paediatric chronic pain, interventional pain management techniques can play an important role when pain is unrelieved by conventional treatment modalities. Many procedures and indications are extrapolated from adult studies, and evidence for long-term efficacy in paediatric populations is limited. Interventions range from injection techniques with local anaesthetic and/or corticosteroids to neuraxial blockade with implanted catheters. Paediatric case series have reported benefit in selected patients with complex regional pain syndrome and cancer-related pain.

Sign in / Sign up

Export Citation Format

Share Document