Category: Health Psychology / Behavioral Medicine - Adult
Introduction: We developed a mobile application (app) to assess pelvic pain and other symptoms in patients with Urological Chronic Pelvic Pain Syndrome (UCPPS) participating in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. The app was designed for Ecological Momentary Assessment (EMA), enabling patients to describe their pain and co-occurring symptoms. Previous studies have shown a relationship between depression and pain in UCPPS using full-length questionnaires; the goal of this study was to determine whether these relationships would still be found using brief app-based questions, as well as to explore participant satisfaction with use of the app.
Methods: Beta testing occurred over 14 days, with app usability measured on Day 15 with the NASA Task Load Index (TLX), followed by a qualitative telephone exit interview. Participants received notifications to prompt them to complete surveys. Notifications were scheduled at normal wakeup time, four and eight hours after awakening and at their bedtime. They located their pain on body maps and rated their pain (scale of 0 to 10) and other symptoms. The app also administered depression and anxiety four-item short forms from the NIH PROMIS (scale of 1 = never to 5 = always). We enrolled 20 participants in the EMA study, however, due to missing data on Day 7, only 12 participants were included in the present analysis. All 20 participants were included in the app usability analysis. We hypothesized that at Week 1 depression score, using anxiety as a covariate, would be positively associated with average pain intensity.
Results: We examined the data cross-sectionally at Week 1, in order to conduct a preliminary analysis on the beta testing data. Accordingly, this analysis provides some insight as to the efficacy of the mobile app in capturing the core symptoms of UCPPS. As hypothesized, results for Week 1 indicated depression was positively related to average pain (β = 0.88, p < .01) even with anxiety as a covariate, ΔR2 = .44, F(1, 9) = 10.92, p < .01. Furthermore, over the 14-day testing period participants were satisfied with the app (e.g., low demand, high performance).
Conclusions: Results indicate that the mobile app provides utility in the assessment of pelvic pain symptoms, depression, and anxiety. Beta testing demonstrated that it may be inadvisable to ask key questions (e.g., about depression) only once per week, because participants may skip any given assessment. Key questions should be considered for inclusion in the daily surveys. Future directions of this line of research include exploring bidirectional, longitudinal relationships among depression, anxiety, and pain, as well as using apps as a communication tool for clinicians. Moreover, accessibility of mobile apps engenders increased clinical participation of more diverse populations.
Bayley Taple– Graduate Student Research Assistant, Northwestern University, Chicago, Illinois
Ted Herman– University of Iowa
Anthony Andrys– University of Iowa
Bradley Erickson– University of Iowa
Michael Bass– Northwestern University
Robert Brett Lloyd– Northwestern University
J. Richard Landis– University of Pennsylvania
Ted Barrell– University of Pennsylvania
Shawn Ballard– University of Pennsylvania
John Farrar– University of Pennsylvania
James Griffith– Northwestern University
Graduate Student Research Assistant