mHealth for pediatric chronic pain: state of the art and future directions

ABSTRACT

Introduction

Chronic pain conditions are common among children and engender cascading effects across social, emotional, and behavioral domains for the child and family. Mobile health (mHealth) describes the practice of delivering healthcare via mobile devices and may be an ideal solution to increase access and reach of evidence-based behavioral health interventions.

Areas covered

The aim of this narrative review is to present a state-of-the-art overview of evidence-based mHealth efforts within the field of pediatric chronic pain and consider new and promising directions for study. Given the nascent nature of the field, published mHealth interventions in all stages of development are discussed. Literature was identified through a non-systematic search in PubMed and Google Scholar, and a review of reference lists of papers that were identified as particularly relevant or foundational (within and outside of the chronic pain literature).

Expert opinion

mHealth is a promising interventional modality with early evidence suggesting it is primed to enhance behavioral health delivery and patient outcomes. There are many exciting future directions to be explored including drawing inspiration from digital health technology to generate new ways of thinking about the optimal treatment of pediatric chronic pain.

KEYWORDS:

• mhealth
• pediatric
• chronic pain
• self-management

Article highlights

• There is a rich literature providing support for the utility of behavioral health interventions in ameliorating pain intensity, functional disability, and comorbid psychiatric conditions associated with pediatric chronic pain

• Widespread availability of behavioral health for pediatric chronic pain is undermined by a shortage of services outside of urban centers, significant treatment-related costs, and long provider waitlists.

• Access to smartphones has become ubiquitous for individuals across developmental groups and socioeconomic backgrounds, rendering mobile health interventions (mHealth) as uniquely suited for the rapid dissemination of interventions across differing healthcare settings.

• mHealth systems for pediatric chronic pain have been developed as symptom diaries, often referred to as ecological momentary assessment (EMA), and to deploy self-management techniques (e.g. psychoeducation, cognitive restructuring, physiological self-regulation, goal-setting, mindfulness).

• In the broader chronic pain and mHealth literatures, there are promising directions and innovations that set the groundwork for the future of digital interventions for pediatric chronic pain, including: transforming care based on digital health technology, translating in-person interventions to the digital sphere, novel service delivery models, and innovative research designs and analyses.

• As mHealth continues to develop as a viable and promising intervention for pediatric chronic pain, multiple research priorities remain, including generating developmentally informed content that is appropriate for differing ages groups, considering cultural adaptations, and evaluating differing mHealth formats. (e.g. self-guided, clinician check-ins, group interventions, personalized vs standardized content).

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.