Background & Aims
Telehomecare monitoring (TM) is a promising tool to support chronic pain (CP) management and improve outcomes through routine timely data transmission, enabling early symptom detection and intervention by healthcare providers. However, existing digital solutions have important limitations such as lack of integrated functionalities for decision support, self-monitoring, and skills development; minimal end-user involvement in codesign, raising concerns about relevance; and insufficient grounding in behavior change theories. [1-5] To address these gaps, this study aims to (1) explore the needs of patients with CP and their providers regarding healthcare delivery and self-management support; (2) identify perceived benefits of using TM beyond clinical encounters for CP management; and (3) codevelop an interactive patient-provider TM platform prototype tailored to previously identified needs.
Methods
Guided by user-centred design principles [6], we employed a multi-phased research approach to facilitate the identification of user needs and support the development of the TM prototype. In Phase 1, semi-structured focus groups were conducted with a convenience sample of 6 patients and a purposive sample of 16 providers recruited from CP clinics. These sessions aimed to identify the perceived needs of users, TM features supporting those needs, and perceived benefits of TM. In Phase 2, purposive sampling was used to select 20 providers, 5 patients, and 7 content experts (CE) in the fields of eHealth and/or research or service delivery in CP. All participants were asked to use findings from Phase 1 to develop the pain care algorithm. Prototype development and iterative refinement, primarily consisting of schematics and sketches describing the main intervention components, occurred through a series of virtual co-design sessions between participants and the technology partner.
Results
Phase 1 identified five overarching themes focused on important user needs: 1) Pain impact; 2) Challenges in care delivery; 3) Limited resources and strategies for CP management; 4) Priority features for TM; and 5) Value proposition of TM. In Phase 2, the development of a TM prototype was guided by ecological momentary assessment methodology. The prototype integrates a symptom questionnaire to assess 10 biopsychosocial domains (e.g., function, sleep, mood), actionable clinical alerts, and tailored advice and education (e.g., pharmacological, physical, psychosocial) guided by a built-in algorithm. Design principles (real-time information sharing, technological literacy, partnership, behavioural activation, capacity-building, actionable monitoring, and human connection) informed modifications to the protype. This phase focused on improved acceptability, usability, and feasibility, emphasizing the importance of using iterative codesign processes in the development of TM solutions.
Conclusions
Participants expressed positive views regarding TM when tailored to address patient and provider needs, and theory-based functionalities (including symptom monitoring, behavioural activation and patient-provider interactions) were considered beneficial to patients with CP. Participants also acknowledged TM’s potential in supporting continuity and coordination of care, therapeutic relationships, and behavior change in CP management. The next phase of the project will use a pre-post design, integrating qualitative and quantitative data, to examine feasibility and preliminary efficacy of the platform. It also aims to assess and document its optimal integration into clinical workflows across various care levels in Québec (Canada) and involving a broad representation of patients, providers and CP conditions.
References
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Presenting Author
Regina Visca
Poster Authors
Regina Visca
OTHR
McGill University Health Centre , Montreal, Quebec, Canada
Lead Author
Stéphanie Cormier
CIUSSS Centre-Ouest-de-l'Ile de Montréal, Quebec, Canada
Lead Author
June Litowski
CIUSSS Centre-Ouest-de-l'Ile de Montréal, Quebec, Canada
Lead Author
Martine Leroux
CIUSSS Centre-Ouest-de-l'Ile de Montréal, Quebec, Canada
Lead Author
Flavie Laliberte
McGill RUISSS Centre of Expertise in Chronic Pain, Montreal, Quebec, Canada
Lead Author
Catherine Rahal
McGill RUISSS Centre of Expertise in Chronic Pain, Montreal, Quebec, Canada
Lead Author
Krista Brecht
McGill University Health Centre , Montreal, Quebec, Canada
Lead Author
Yoram Shir
McGill University Health Centre , Montreal, Quebec, Canada
Lead Author
Topics
- Access to Care