A mobile health intervention to support patients with chronic pain during opioid tapering

Abstract

Patients with chronic non-cancer pain on long-term opioid therapy are often advised to taper their dose when the risks of continued use outweigh the benefits. However, they report difficulties with opioid tapering, necessitating the development of, and access to, supportive interventions. Using co-design methodology, we developed a mobile health intervention consisting of a psychoeducational video and daily text messages. We tested its feasibility, acceptability, and potential efficacy in a pilot randomised trial. Participants were recruited from three multidisciplinary pain clinics in Sydney and Adelaide and were randomised to receive the intervention in addition to their usual care for 4 weeks. The acceptability, feasibility, and potential efficacy of the intervention were assessed. Of 28 enrolled participants, 26 completed the pilot study. SMS delivery was 99% and acceptability was 78%. Opioid tapering self-efficacy (Cohen’s d = 0.74) and pain self-efficacy (d = 0.41) were higher and pain intensity (d = 0.65) and affective interference (d = 0.45) were lower in the intervention compared to the control group at week 4. Participants (64%) noted a desire for the intervention to continue longer than 4 weeks. A larger trial has been initiated to test the efficacy of a 12-week intervention. In the current ongoing trial, participants are recruited from the community, via social media. This approach has resulted in the recruitment of a more diverse population (from six states; 55% from rural/regional areas). It is feasible, acceptable, and potentially efficacious to support patients during opioid tapering with a co-designed mobile health intervention. Recruitment from the community via social media can accelerate trials and help to make pain research more inclusive.