Psychotherapy and psychosomatics · 2026
Clinical Effectiveness of Different Feedback Intensities in a Pain Management App: A Multicenter Randomized Controlled Trial with Youths with Chronic Pain and Their Caregivers.
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Schmidt Amelie Florentine, Meyer Dorothee, Rau Lisa-Marie, Hirschfeld Gerrit, Frosch Michael, Frühwald Michael C, Ahnert Rosemarie, Höfel Lea, Storf Magdalena, Blankenburg Markus, Steinert Kerstin, Schneider Udo, Marschall Ursula, Wager Julia, Zernikow Boris
Аннотация
INTRODUCTION: Many children and adolescents suffer from high-impact chronic pain. While preliminary evidence suggests that intensive interdisciplinary pain treatment is effective, there is limited post-treatment support. Individualized support through a pain management app may help close this gap.
METHODS: We conducted a multicenter randomized controlled trial with N = 453 youths with chronic pain aged 8-17 and their caregivers. Participants had access to the app MyBrainCity from admission until 6 months following discharge. Immediately after discharge, participants had access to either (1) app usage statistics (reference group), (2) plus push notifications and suggestions, (3) plus on-demand chat communication with a psychologist, or (4) plus psychologist-initiated chat communication. Data were collected up to 9 months after discharge. Outcomes included the functional disability inventory, the Revised Anxiety and Depression Scale, and numeric rating scales to assess pain intensity.
RESULTS: The primary analysis showed no significant differences in functional impairment between groups 9 months post-discharge (χ2(3) = 6.122, p = 0.106). Secondary analyses revealed that patients in Groups 3 and 4 showed significantly greater improvements in functional impairment compared to the reference group (-1.13 points, p < 0.001). Only patients in Group 4 demonstrated additional improvements in emotional burden (anxiety: -0.91 points, p < 0.001; depression: -0.72 points, p = 0.012). Patients in Group 2 had significantly greater reductions in both average (-0.24 points, p = 0.007) and maximum pain intensity (-0.33 points, p = 0.001) compared to the reference group.
CONCLUSIONS: Pediatric pain management apps may be most effective when designed to include individualized, personal support. Patients especially benefit from clinician-delivered feedback following discharge.
METHODS: We conducted a multicenter randomized controlled trial with N = 453 youths with chronic pain aged 8-17 and their caregivers. Participants had access to the app MyBrainCity from admission until 6 months following discharge. Immediately after discharge, participants had access to either (1) app usage statistics (reference group), (2) plus push notifications and suggestions, (3) plus on-demand chat communication with a psychologist, or (4) plus psychologist-initiated chat communication. Data were collected up to 9 months after discharge. Outcomes included the functional disability inventory, the Revised Anxiety and Depression Scale, and numeric rating scales to assess pain intensity.
RESULTS: The primary analysis showed no significant differences in functional impairment between groups 9 months post-discharge (χ2(3) = 6.122, p = 0.106). Secondary analyses revealed that patients in Groups 3 and 4 showed significantly greater improvements in functional impairment compared to the reference group (-1.13 points, p < 0.001). Only patients in Group 4 demonstrated additional improvements in emotional burden (anxiety: -0.91 points, p < 0.001; depression: -0.72 points, p = 0.012). Patients in Group 2 had significantly greater reductions in both average (-0.24 points, p = 0.007) and maximum pain intensity (-0.33 points, p = 0.001) compared to the reference group.
CONCLUSIONS: Pediatric pain management apps may be most effective when designed to include individualized, personal support. Patients especially benefit from clinician-delivered feedback following discharge.