E3 PreliminaryPreliminaryPEM not requiredMethods-PaperPeer-reviewedMachine draft
User-Driven Development of a Digital Behavioral Intervention for Chronic Pain: Multimethod Multiphase Study.
Taygar, Afra Selma, Bartels, Sara Laureen, de la Vega, Rocío et al. · JMIR formative research · 2025 · DOI
Quick Summary
This study asked patients with chronic pain and therapists what they wanted in a digital app to help manage their pain. Researchers created fictional patient profiles, held focus groups to understand needs, and then tested a prototype app with real patients. The final 6-week app included flexible features like short sessions, easy navigation, and different ways to contact a therapist. Patients found it helpful and easy to use.
Why It Matters
ME/CFS patients often experience comorbid chronic pain and face barriers to accessing behavioral pain management due to post-exertional malaise and limited healthcare availability. This study's emphasis on digital accessibility, asynchronous contact options, and flexible dose (microsessions) directly addresses common constraints for severely ill ME/CFS patients. The inclusion of chronic fatigue syndrome in the diverse pain cohort suggests relevance to ME/CFS populations.
Observed Findings
- Patients rated the intervention as helpful (mean 4.27–5.45/7), enjoyable (mean 3.81–4.81/7), and understandable (mean 4.45–6/7) during weekly pilot testing.
- End users emphasized need for accessibility, tailored content, flexibility in therapist contact (asynchronous messaging, phone, video), short microsessions, and intuitive navigation.
- One of 11 pilot patients had undiagnosed chronic pain; one had hypermobile Ehlers-Danlos syndrome; one had chronic fatigue syndrome; others had diverse pain diagnoses (migraine, arthritis, fibromyalgia, complex regional pain syndrome, herniated disc).
- Focus groups highlighted specific design requests: video content, text-to-speech function, and add-on modules.
Inferred Conclusions
- User-centered, iterative co-design involving patients and therapists successfully produced a digital chronic pain intervention with acceptable usability and perceived helpfulness.
- Digital behavioral interventions for chronic pain should prioritize flexibility, accessibility, and short-duration sessions to accommodate diverse patient needs and limitations.
- The integration of patient personas, focus groups, and pilot testing provides an evidence-based framework for developing patient-centric digital health tools.
Remaining Questions
- Does the intervention demonstrate efficacy in reducing pain intensity, improving function, or enhancing quality of life in a larger randomized trial?
What This Study Does Not Prove
This study does not demonstrate the efficacy of the digital intervention for reducing pain, improving function, or preventing post-exertional malaise; it only establishes acceptability and usability. The study does not compare this intervention to standard care or placebo, and the small pilot sample (n=11) cannot support generalizable effectiveness claims. Long-term outcomes and adherence rates remain unknown.
Tags
Symptom:Pain
Method Flag:Small SampleExploratory Only
Metadata
- DOI
- 10.2196/74064
- PMID
- 40627437
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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