Mayo Clinic proceedings. Digital health · 2026
The Influence of Mobile Health Interventions on Aftercare and Medication Use for Patients With Chronic Pain: A Systematic Review.
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Neetens Tom W A, Hiemstra Bart, Edward Gitara M, Kool Rudolf B, Roozekrans Margot H J, Hollmann Markus W, Timmers Thomas
Аннотация
OBJECTIVE: To evaluate the impact of mobile health interventions (MHIs) on opioid use, nonopioid medication use, adherence, quality-adjusted life years (QALYs), and health care utilization among adults with chronic pain.
PATIENTS AND METHODS: A systematic review (PROSPERO CRD4202457819) was conducted using PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library from April 23, 2024, to May 2, 2025. Randomized controlled trials (RCTs) evaluating mobile-accessible interventions for adults aged 18-65 years with chronic pain, low back pain, or chronic low back pain were included. Two reviewers independently screened studies and assessed risk of bias. Owing to heterogeneity, outcomes were synthesized narratively, and standardized mean differences were calculated when appropriate.
RESULTS: Fourteen trials (n=3766) met inclusion criteria. Six studies (n=1098) evaluated opioid use, with 4 reporting significant reductions. All 5 studies assessing nonopioid medication use (n=810) demonstrated decreases. Of 4 studies examining adherence (n=851), 3 showed improvement. QALY gains were observed in 4 of 5 studies (n=2252), although effect sizes were small. No significant reductions in health care utilization were identified across included trials.
CONCLUSION: Mobile health interventions reduce opioid and nonopioid medication use and improve adherence in adults with chronic pain. Evidence for QALY improvement is modest, and effects on health care utilization remain uncertain. Moreover, MHIs serve as valuable adjuncts to chronic pain care, particularly for medication stewardship. Further high-quality, long-term randomized trials using standardized outcome measures are needed.
PATIENTS AND METHODS: A systematic review (PROSPERO CRD4202457819) was conducted using PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library from April 23, 2024, to May 2, 2025. Randomized controlled trials (RCTs) evaluating mobile-accessible interventions for adults aged 18-65 years with chronic pain, low back pain, or chronic low back pain were included. Two reviewers independently screened studies and assessed risk of bias. Owing to heterogeneity, outcomes were synthesized narratively, and standardized mean differences were calculated when appropriate.
RESULTS: Fourteen trials (n=3766) met inclusion criteria. Six studies (n=1098) evaluated opioid use, with 4 reporting significant reductions. All 5 studies assessing nonopioid medication use (n=810) demonstrated decreases. Of 4 studies examining adherence (n=851), 3 showed improvement. QALY gains were observed in 4 of 5 studies (n=2252), although effect sizes were small. No significant reductions in health care utilization were identified across included trials.
CONCLUSION: Mobile health interventions reduce opioid and nonopioid medication use and improve adherence in adults with chronic pain. Evidence for QALY improvement is modest, and effects on health care utilization remain uncertain. Moreover, MHIs serve as valuable adjuncts to chronic pain care, particularly for medication stewardship. Further high-quality, long-term randomized trials using standardized outcome measures are needed.