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Validity, Reliability, Feasibility, and Usefulness of Pain Monitor

A Multidimensional Smartphone App for Daily Monitoring of Adults With Heterogenous Chronic Pain

Suso-Ribera, Carlos, PhD*; Castilla, Diana, PhD*,†; Zaragozá, Irene, PhD; Ribera-Canudas, María Victoria, MD, PhD; Botella, Cristina, PhD*,†; García-Palacios, Azucena, PhD*,†

doi: 10.1097/AJP.0000000000000618
Original Articles

Objectives: Ecological momentary assessment has been recommended in the management of chronic pain. Smartphone apps might be a useful tool for that purpose. This goal of this study was to develop and test a multidimensional smartphone app for adults with chronic pain. A multidisciplinary team developed the app content after a series of meetings, considering clinical guidelines for pain measurement. The content included pain intensity and interference, fatigue, mood, perceived health status, activity level, side effects of the medication, use of rescue medication, and pain-related sychological constructs (catastrophizing, acceptance, fear, and coping).

Methods: Thirty-eight participants (21 to 59 y) used the app, called Pain Monitor, twice a day during 30 consecutive days. Patients completed a set of well-established measures at the beginning and end of the study via paper-and-pencil. Weekly phone assessments were also made for pain intensity, pain interference, fatigue, and mood.

Results: Construct validity was revealed by moderate-to-strong correlations between app content and traditional measures. Feasibility was supported by high compliance (between 70% and 82%) and high acceptability and ease of use. Both side effects of the medication and use of rescue medication were found to be useful tools to guide treatment.

Discussion: The new assessment protocol in the app allows for an easy and rapid multidimensional assessment of chronic pain patients.

*Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon

CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, Madrid

Pain Clinic, Valld’Hebron Hospital, Barcelona, Spain

C.S.-R., D.C., M.V.R.-C., C.B., and A.G.-P.: developed app content after a set of meetings together with a team of physicians and nurses at the Pain Clinic of the Valld’Hebron Hospital. D.C. and I.Z.: designed the app. All authors could make comments on app design until an agreement was made. C.S.-R. and M.V.R.-C.: in charge of participant recruitment. C.S.-R.: in charge of conducting the analyses, which were then discussed by all coauthors and was in charge of elaborating a first draft of the manuscript, on which all coauthors commented. Two drafts were reviewed by all authors until an agreement was reached on this final version.

This project was partially supported by grant POSDOC/2016/15 (Jaume I University, Castellon de la Plana, Spain) and grant UJI-B2016-39 (Plan de Promoción de la investigación 2016, Jaume I University, Castellon de la Plana, Spain). None of the authors receive any financial compensation related to the use of the app. The authors declare no conflict of interest.

Reprints: Carlos Suso-Ribera, PhD, Av. de Vicent Sos Baynat, s/n, Castellon de la Plana 12071, Spain (e-mail:

Received December 29, 2017

Received in revised form April 3, 2018

Accepted April 4, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.