Abstract：
Chronic pain (CP) is 1 of the leading causes of disability worldwide and represents a significant burden on individual, social, and economic aspects. Potential tools, such as mobile health (mHealth) systems, are emerging for the self-management of patients with CP.
A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional treatment or nonintervention.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to conduct a systematic review of randomized controlled trials (RCTs) published in PubMed, Web of Science, Scopus, and Physiotherapy Evidence Database (PEDro) databases from February to March 2022. No filters were used. The eligibility criteria were RCTs of adults (≥18 years old) with CP, intervened with mHealth systems based on mobile apps for monitoring pain and health-related outcomes, for pain and behavioral self-management, and for performing therapeutic approaches, compared to conventional treatments (physical, occupational, and psychological therapies; usual medical care; and education) or nonintervention, reporting pain intensity, QoL, and functional disability. The methodological quality and risk of bias (RoB) were assessed using the Checklist for Measuring Quality, the Oxford Centre for Evidence-Based Medicine Levels of Evidence, and the Cochrane RoB 2.0 tool.
In total, 22 RCTs, involving 2641 patients with different CP conditions listed in the International Classification of Diseases 11th Revision (ICD-11), including chronic low back pain (CLBP), chronic musculoskeletal pain (CMSP), chronic neck pain (CNP), unspecified CP, chronic pelvic pain (CPP), fibromyalgia (FM), interstitial cystitis/bladder pain syndrome (IC/BPS), irritable bowel syndrome (IBS), and osteoarthritis (OA). A total of 23 mHealth systems were used to conduct a variety of CP self-management strategies, among which monitoring pain and symptoms and home-based exercise programs were the most used. Beneficial effects of the use of mHealth systems in reducing pain intensity (CNP, FM, IC/BPS, and OA), QoL (CLBP, CNP, IBS, and OA), and functional disability (CLBP, CMSP, CNP, and OA) were found. Most of the included studies (18/22, 82%) reported medium methodological quality and were considered as highly recommendable; in addition, 7/22 (32%) studies had a low RoB, 10/22 (45%) had some concerns, and 5/22 (23%) had a high RoB.
The use of mHealth systems indicated positive effects for pain intensity in CNP, FM, IC/BPS, and OA; for QoL in CLBP, CNP, IBS, and OA; and for functional disability in CLBP, CMSP, CNP, and OA. Thus, mHealth seems to be an alternative to improving pain-related outcomes and QoL and could be part of multimodal strategies for CP self-management. High-quality studies are needed to merge the evidence and recommendations of the use of mHealth systems for CP management.
PROSPERO International Prospective Register of Systematic Reviews CRD42022315808; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315808.
A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional treatment or nonintervention.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to conduct a systematic review of randomized controlled trials (RCTs) published in PubMed, Web of Science, Scopus, and Physiotherapy Evidence Database (PEDro) databases from February to March 2022. No filters were used. The eligibility criteria were RCTs of adults (≥18 years old) with CP, intervened with mHealth systems based on mobile apps for monitoring pain and health-related outcomes, for pain and behavioral self-management, and for performing therapeutic approaches, compared to conventional treatments (physical, occupational, and psychological therapies; usual medical care; and education) or nonintervention, reporting pain intensity, QoL, and functional disability. The methodological quality and risk of bias (RoB) were assessed using the Checklist for Measuring Quality, the Oxford Centre for Evidence-Based Medicine Levels of Evidence, and the Cochrane RoB 2.0 tool.
In total, 22 RCTs, involving 2641 patients with different CP conditions listed in the International Classification of Diseases 11th Revision (ICD-11), including chronic low back pain (CLBP), chronic musculoskeletal pain (CMSP), chronic neck pain (CNP), unspecified CP, chronic pelvic pain (CPP), fibromyalgia (FM), interstitial cystitis/bladder pain syndrome (IC/BPS), irritable bowel syndrome (IBS), and osteoarthritis (OA). A total of 23 mHealth systems were used to conduct a variety of CP self-management strategies, among which monitoring pain and symptoms and home-based exercise programs were the most used. Beneficial effects of the use of mHealth systems in reducing pain intensity (CNP, FM, IC/BPS, and OA), QoL (CLBP, CNP, IBS, and OA), and functional disability (CLBP, CMSP, CNP, and OA) were found. Most of the included studies (18/22, 82%) reported medium methodological quality and were considered as highly recommendable; in addition, 7/22 (32%) studies had a low RoB, 10/22 (45%) had some concerns, and 5/22 (23%) had a high RoB.
The use of mHealth systems indicated positive effects for pain intensity in CNP, FM, IC/BPS, and OA; for QoL in CLBP, CNP, IBS, and OA; and for functional disability in CLBP, CMSP, CNP, and OA. Thus, mHealth seems to be an alternative to improving pain-related outcomes and QoL and could be part of multimodal strategies for CP self-management. High-quality studies are needed to merge the evidence and recommendations of the use of mHealth systems for CP management.
PROSPERO International Prospective Register of Systematic Reviews CRD42022315808; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315808.
摘要：
背景：慢性疼痛（CP）是全球残疾的主要原因之一，对个人构成重大负担，社会,和经济方面。潜在工具,如移动健康(mHealth)系统，正在出现CP患者的自我管理。
目的：进行了系统评价，以分析mHealth干预措施对CP管理的影响，根据疼痛强度，生活质量（QoL），和功能残疾评估，与常规治疗或非干预相比。
方法：遵循PRISMA（系统评价和荟萃分析的首选报告项目）指南，对PubMed上发表的随机对照试验（RCT）进行系统评价，WebofScience,Scopus,和物理治疗证据数据库（PEDro）数据库从2月到2022年3月。没有使用过滤器。资格标准为成人（≥18岁）CP的RCT，使用基于移动应用程序的移动健康系统进行干预，以监测疼痛和健康相关结果，疼痛和行为自我管理，为了进行治疗方法，与常规治疗相比(物理，职业,和心理治疗；常规医疗；和教育)或非干预，报告疼痛强度，QoL,功能性残疾。方法学质量和偏倚风险（RoB）使用质量测量清单进行评估，牛津循证医学中心的证据水平，和CochraneRoB2.0工具。
结果：总计，22项随机对照试验,涉及2641名患有国际疾病分类第11修订版（ICD-11）中列出的不同CP状况的患者，包括慢性腰痛（CLBP），慢性肌肉骨骼疼痛（CMSP），慢性颈痛（CNP），未指定CP,慢性盆腔疼痛（CPP），纤维肌痛（FM），间质性膀胱炎/膀胱疼痛综合征（IC/BPS），肠易激综合征（IBS），骨关节炎（OA）。总共使用了23个mHealth系统来执行各种CP自我管理策略，其中最常用的是监测疼痛和症状以及基于家庭的锻炼计划。使用mHealth系统降低疼痛强度的有益效果(CNP，FM,IC/BPS,和OA)，QoL（CLBP，CNP,IBS,和OA)，和功能障碍(CLBP，CMSP,CNP,和OA）被发现。大多数纳入的研究（18/22，82%）报告了中等的方法学质量，被认为是高度推荐的；此外，7/22（32％）研究的RoB较低，10/22（45%）有一些担忧，5/22(23%)的RoB较高。
结论：使用mHealth系统对CNP的疼痛强度有积极影响，FM,IC/BPS,和OA；对于CLBP中的QoL，CNP,IBS,和OA；对于CLBP的功能障碍，CMSP,CNP,和OA。因此，mHealth似乎是改善疼痛相关结局和QoL的替代方法，并且可能是CP自我管理的多模式策略的一部分。需要高质量的研究来合并使用mHealth系统进行CP管理的证据和建议。
背景：PROSPERO国际系统评价前瞻性注册CRD42022315808;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=315808。
目的：进行了系统评价，以分析mHealth干预措施对CP管理的影响，根据疼痛强度，生活质量（QoL），和功能残疾评估，与常规治疗或非干预相比。
方法：遵循PRISMA（系统评价和荟萃分析的首选报告项目）指南，对PubMed上发表的随机对照试验（RCT）进行系统评价，WebofScience,Scopus,和物理治疗证据数据库（PEDro）数据库从2月到2022年3月。没有使用过滤器。资格标准为成人（≥18岁）CP的RCT，使用基于移动应用程序的移动健康系统进行干预，以监测疼痛和健康相关结果，疼痛和行为自我管理，为了进行治疗方法，与常规治疗相比(物理，职业,和心理治疗；常规医疗；和教育)或非干预，报告疼痛强度，QoL,功能性残疾。方法学质量和偏倚风险（RoB）使用质量测量清单进行评估，牛津循证医学中心的证据水平，和CochraneRoB2.0工具。
结果：总计，22项随机对照试验,涉及2641名患有国际疾病分类第11修订版（ICD-11）中列出的不同CP状况的患者，包括慢性腰痛（CLBP），慢性肌肉骨骼疼痛（CMSP），慢性颈痛（CNP），未指定CP,慢性盆腔疼痛（CPP），纤维肌痛（FM），间质性膀胱炎/膀胱疼痛综合征（IC/BPS），肠易激综合征（IBS），骨关节炎（OA）。总共使用了23个mHealth系统来执行各种CP自我管理策略，其中最常用的是监测疼痛和症状以及基于家庭的锻炼计划。使用mHealth系统降低疼痛强度的有益效果(CNP，FM,IC/BPS,和OA)，QoL（CLBP，CNP,IBS,和OA)，和功能障碍(CLBP，CMSP,CNP,和OA）被发现。大多数纳入的研究（18/22，82%）报告了中等的方法学质量，被认为是高度推荐的；此外，7/22（32％）研究的RoB较低，10/22（45%）有一些担忧，5/22(23%)的RoB较高。
结论：使用mHealth系统对CNP的疼痛强度有积极影响，FM,IC/BPS,和OA；对于CLBP中的QoL，CNP,IBS,和OA；对于CLBP的功能障碍，CMSP,CNP,和OA。因此，mHealth似乎是改善疼痛相关结局和QoL的替代方法，并且可能是CP自我管理的多模式策略的一部分。需要高质量的研究来合并使用mHealth系统进行CP管理的证据和建议。
背景：PROSPERO国际系统评价前瞻性注册CRD42022315808;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=315808。
