E3 PreliminaryPreliminaryPEM not requiredMethods-PaperPeer-reviewedReviewed
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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.
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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