Smartphone app helps patients with cancer manage pain

Patients with metastatic solid tumors who used an artificial intelligence-based smartphone app reported significantly reduced pain and had fewer hospital admissions, according to results of a randomized controlled trial presented at Palliative and Supportive Care in Oncology Symposium.

The app, called ePAL, monitored and helped patients address pain related to advanced cancer.

“There is a significant shortage of palliative care providers, which will only worsen in the future as our population grows,” Mihir M. Kamdar, MD, associate director of the division of palliative care and interventional pain physician at Massachusetts General Hospital, said in a press release. “This is one of the reasons why technology solutions to help manage palliative care challenges, such as cancer pain, are so important.”

Cancer pain affects 70% to 90% of patients with advanced disease, resulting in poorer quality of life and increased use of health care resources, according to study background.

The study included 112 patients with pain from metastatic cancer.

Kamdar and colleagues randomly 56 patients to a control group that received standard care for 8 weeks. The other 56 patients were assigned to an intervention group that used the ePAL app in addition to standard care.

Patients in the intervention group received alerts on their smartphones with tips for daily pain management and reported their pain levels on a scale of 0-10. The app assessed pain 3 times a week, distinguishing urgent from nonurgent pain, and provided feedback to patients in real time.

If cancer pain was severe or worsening, the app connected the patient to a nurse who responded within an hour.

If patients experienced moderate pain, the app asked them questions and electronically advised them on how to manage it.

Questionnaires about pain severity, attitudes toward cancer pain treatment and general anxiety were given at the start, midpoint and end of the study.

All patients had similar pain levels at the start of the study, with a mean score of 4 out of 10 on the pain scale.

After 8 weeks, pain levels did not change among patients assigned to the control group. However, pain levels among patients assigned the intervention declined by 20% to a mean score of 2.99 on the 10-point scale.

Negative attitudes towards cancer pain treatment also decreased significantly among patients in the intervention group compared with controls (P = .042).

General anxiety scores increased from 6.67 to 7.68 out of a possible 21 among the intervention group, but scores decreased slightly — from 5.9 to 5.03 — among the control group. Patients who reported pain more than twice a week via the app did not experience any increase in anxiety.

Overall, researchers reported fewer pain-related inpatient hospital admissions among the intervention group than the control group (4 vs. 20).

The researchers plan to develop a larger artificial intelligence telehealth platform and study it in other clinical settings.

“The vast majority of people with cancer experience pain at some point, and we need better tools to track and report it,” Joshua Adam Jones, MD, MA, assistant professor of clinical radiation oncology at University of Pennsylvania’s Perelman School of Medicine and chairman of the Palliative and Supportive Care in Oncology Symposium news planning team, said in the press release. “My hope is that these findings will pave the way for more widespread use of apps among patients who are experiencing pain, so that they can get the support they need.”– by John DeRosier

Reference:

Kamdar M, et al. Abstract #76. Presented at: Palliative and Supportive Care in Oncology Symposium; Nov. 16-17, 2018; San Diego.

Disclosure s : Kamdar reports stock/ownership interests in and a consultant/advisory role with Amorsa Therapeutics. Please see the abstract for all other authors’ relevant financial disclosures.