The iCanCope pain self-management application for adolescents with juvenile idiopathic arthritis: a pilot randomized controlled trial.

Creator(s)

Chitra Lalloo
Lauren R. Harris
Amos S. Hundert
Roberta Berard
Joseph Cafazzo
Mark Connelly, Children's Mercy HospitalFollow
Brian M. Feldman
Kristin Houghton
Adam Huber
Ronald M. Laxer
Nadia Luca
Heinrike Schmeling
Lynn Spiegel
Lori B. Tucker
Quynh Pham
Cleo C. Davies-Chalmers
Jennifer N. Stinson

Document Type

Article

Publication Date

1-5-2021

Identifier

DOI: 10.1093/rheumatology/keaa178

Abstract

OBJECTIVES: To evaluate the feasibility and preliminary effectiveness of iCanCope with Pain (iCanCope), a smartphone-based pain self-management program, in adolescents with JIA. iCanCope featured symptom tracking, goal-setting, pain coping skills and social support.

METHODS: A two-arm pilot randomized controlled trial was used to evaluate the iCanCope app compared with a version with symptom tracking only. Primary (feasibility) outcomes were: participant accrual/attrition rates, success of app deployment, acceptability and adherence. Secondary (preliminary effectiveness) outcomes were: pain intensity, pain-related activity limitations and health-related quality of life. Outcomes were assessed at baseline and 8 weeks. Adherence was defined as the proportion of completed symptom reports: 'low' (≤24%); 'low-moderate' (25-49%); 'high-moderate' (50-75%); or 'high' (76-100%). Linear mixed models were applied for preliminary effectiveness analyses as per intention-to-treat.

RESULTS: Adolescents (N = 60) were recruited from three paediatric rheumatology centres. Rates of accrual and attrition were 82 and 13%, respectively. Both apps were deployed with high success (over 85%) and were rated as highly acceptable. Adherence was similar for both groups, with most participants demonstrating moderate-to-high adherence. Both groups exhibited a clinically meaningful reduction in pain intensity (≥1 point) that did not statistically differ between groups. There were no significant changes in activity limitations or health-related quality of life.

CONCLUSION: The iCanCope pilot randomized controlled trial was feasible to implement in a paediatric rheumatology setting. Both apps were deployed successfully, with high acceptability, and were associated with moderate-to-high adherence. Preliminary reductions in pain intensity warrant a future trial to evaluate effectiveness of iCanCope in improving health outcomes in adolescents with JIA.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02764346.

Journal Title

Rheumatology (Oxford, England)

Volume

60

Issue

1

First Page

196

Last Page

206

Keywords

juvenile idiopathic arthritis; pain; pilot randomized controlled trial; self-management; smartphone.

Recommended Citation

Lalloo C, Harris LR, Hundert AS, et al. The iCanCope pain self-management application for adolescents with juvenile idiopathic arthritis: a pilot randomized controlled trial. Rheumatology (Oxford). 2021;60(1):196-206. doi:10.1093/rheumatology/keaa178