Children, like adults, can experience moderate to severe pain following surgery – approximately 20% develop chronic post-surgical pain (CPSP), an expensive and debilitating health problem. Therefore, novel approaches informed by theory and evidence are needed to improve post-operative pain outcomes.
M-health and e-health interventions have been used successfully to manage paediatric pain. Researchers from University of Toronto and SickKids (The Hospital for Sick Children, Toronto), developed a suite of mobile app interventions (e.g., Pain Squad and iCanCope,) to assist children and adolescents with chronic pain, arthritis, and sickle cell disease. These mobile applications feature computerised clinical decision support systems, creating personalised treatment paths and improved patient outcomes. Recently the Canadian group launched iCanCope PostOp app which includes 4 core features: symptom tracking, SMART goal-setting to improve pain and function, pain self-management coping strategies, and peer-based support. We believe the app can be modified and extended to addreess the risk of CPSP after more major surgeries. We will work collaboratively with the SickKids team to adapt their app to the Irish context for adolescents undergoing major orthopaedic surgery and then explore it’s feasibility, acceptability and effectiveness.
We propose to meaningfully include stakeholders across the various workpackages.
Workpackage 1: A user-centred approach will be used to develop Irish-specific elements of iCanCope PostOp app Exploration with a small cohort of adolescents and their families following in-hosptial stay surgery to determine what supports would have been helpful and then adapt and evaluate iCANCope PostOp app. Health professionals will be invited to share their views on information and supports to be incorporated into the app.
Workpackage 2: Usability testing – is the iCanCope PostOp app a viable tool to facilitate effective pain self-management following surgery in adolescents (is it user-friendly, feasible, and acceptable?).
Workpackage 3: Pilot RCT methodology to evaluate impact of iCanCope PostOp on key health outcomes including risk of CPSP with 60, 12-18 year-olds.
Workpackage 4: SWAT – assess if an adolescent-appropriate video developed to explain participation in RCTs affects recruitment and retention in order to inform the protocol of a definitive iCANCope PostOp RCT.
