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The iCanCope pain self-management application for adolescents with juvenile idiopathic arthritis: A pilot randomized controlled trial
Rheumatology (United Kingdom)
  • Chitra Lalloo, Hospital for Sick Children University of Toronto
  • Lauren R. Harris, Hospital for Sick Children University of Toronto
  • Amos S. Hundert, Hospital for Sick Children University of Toronto
  • Roberta Berard, London Health Sciences Centre
  • Joseph Cafazzo, Institute of Health Policy, Management and Evaluation
  • Mark Connelly, Division of Developmental and Behavioural Health
  • Brian M. Feldman, Hospital for Sick Children University of Toronto
  • Kristin Houghton, BC​ Children​'​​s Hospital
  • Adam Huber, IWK Health Centre
  • Ronald M. Laxer, Hospital for Sick Children University of Toronto
  • Nadia Luca, Alberta Children's Hospital
  • Heinrike Schmeling, Alberta Children's Hospital
  • Lynn Spiegel, Hospital for Sick Children University of Toronto
  • Lori B. Tucker, BC​ Children​'​​s Hospital
  • Quynh Pham, Institute of Health Policy, Management and Evaluation
  • Cleo C. Davies-Chalmers, Hospital for Sick Children University of Toronto
  • Jennifer N. Stinson, Hospital for Sick Children University of Toronto
Document Type
Article
Publication Date
1-1-2021
URL with Digital Object Identifier
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.

Citation Information
Chitra Lalloo, Lauren R. Harris, Amos S. Hundert, Roberta Berard, et al.. "The iCanCope pain self-management application for adolescents with juvenile idiopathic arthritis: A pilot randomized controlled trial" Rheumatology (United Kingdom) Vol. 60 Iss. 1 (2021) p. 196 - 206
Available at: http://works.bepress.com/roberta-berard/28/