Evaluating digitally-enabled self-experiments in general practice to support patients managing persistent pain
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Background
Despite somewhat limited evidence, non-pharmacological, self-management interventions are often recommended for general practice patients with persistent pain. StudyU is an open-source digital platform designed to help patients undertake self-experiments, using a single case experimental design, to test whether these interventions are personally effective.
Aim
To investigate the feasibility and acceptability of integrating digitally-enabled self-experiments in the general practice care of patients with persistent pain.
Design and setting
We will recruit 50 patients from a large Australian general practice. Participants trial a self-selected, self-management intervention (such as a physical activity, mindfulness practice, or online, self-guided cognitive behavioural therapy) approved by their general practitioner (GP), and use the StudyU app to rate the daily impact of their pain over the 10-week study period. The primary clinical outcome of the self-experiments is mean difference in pain interference (measured using the modified Brief Pain Inventory) between baseline (usual routine) and intervention conditions. Clinical reports are generated for the patient and their GP.
Method
We use validated measures of app usability and acceptance, pre/post measures of patient self-efficacy, quality of life, health service use and self-reported health, individual interviews informed by Normalisation Process Theory, and a nested process evaluation to examine the feasibility and acceptability for patients and practice staff of embedding these self-experiments in general practice care.
Conclusion
Digitally-enabled self-experiments testing non-pharmacological treatment effectiveness may empower patients to self-manage persistent pain, in partnership with their GPs, and provide a model for integrating other new technology for patients with other chronic conditions.
HOW THIS FITS IN
In spite of somewhat limited evidence, non-pharmacological, self-management interventions are generally recommended for general practice patients with persistent pain, a distressing and costly condition. Digitally-enabled single-case experimental designs may be a useful approach to assessing the individual effectiveness of self-management interventions. This research will provide evidence about the acceptability and feasibility (for patients, clinicians and other practice staff) of integrating digitally enabled self-experiments into general practice care.
