Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Aug 21, 2020)
Date Submitted: May 3, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
CBT-based App for Women Experiencing Chronic Pelvic Pain: A Pilot Study
ABSTRACT
Background:
Chronic Pelvic Pain (CPP) is a costly and distressing condition and while psychological interventions are effective, they are often not utilised or available. Cost, stigma and lack of time are often presented as reasons for why some women with CPP do not engage with these therapies. Increasingly, technology-mediated therapies have been adopted in the management of long-term health conditions to help overcome barriers commonly associated with face-to-face interventions.
Objective:
The objective of the study was to design and pilot a technology-based intervention for women experiencing CPP. We employed a user-centered approach involving women with CPP and clinicians in the co-design process.
Methods:
To co-design the intervention we conducted five participatory design workshops at a public hospital for women. The data gathered informed the design of an app-based intervention called appEase. We pilot tested appEase with women (N = 16) who were asked to use the app daily over 28 days. Data collected during the pilot included a series of baseline, mid- and post-intervention measures, and usage data collected from within the app.
Results:
Workshop findings suggested that a smartphone application, appEase, that delivers a course in mindfulness, pain education and Cognitive Behaviour Therapy (CBT) was consistent with the goals and needs of this patient group. Pilot testing indicated that although appEase was designed to be used for a period of 28 days, the mean completion time for the intervention was 64 days. Ten participants (63%) experienced clinically significant reductions in Pain Catastrophising (PC), and nine (56%) experienced clinically significant increases in Pain Self-Efficacy (PSE). When asked how confident they would be in recommending the program to a person with chronic pain, the mean rating was 8.44 (out of 10).
Conclusions:
Psychological therapy embodied in a smartphone app shows promise for women experiencing CPP. This study highlights the importance of co-design and provides a useful exemplar for designers of technology-mediated health programs for women experiencing CPP. Furthermore, it has produced a sound empirical basis for testing the efficacy of appEase in a randomised control trial. Clinical Trial: Not registered as it is a pilot study with no funding from national agencies
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