Background/Purpose: Pain is the most common symptom of Juvenile Idiopathic Arthritis (JIA), a chronic childhood illness that has potentially debilitating effects on health-related quality of life (HRQL). iCanCope is a smartphone-based program developed to provide accessible, evidence-based self-management support for adolescents with JIA pain. It was developed through a phased, user-centred approach that involved youth with JIA at every stage. iCanCope provides features of daily symptom tracking, goal-setting, pain coping skills, and social support. The purpose of this study was to evaluate feasibility and preliminary effectiveness of the iCanCope app in adolescents (aged 12-18 years) with JIA pain.
Methods: A 2-arm pilot randomized controlled trial (RCT) was used to evaluate the iCanCope app compared to a version with symptom tracking only. Adolescents who met the ACR classification criteria for JIA and experienced arthritis-related pain >3/10 in the past week were recruited from 3 Canadian paediatric rheumatology centres.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 (HRQL). 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%); “high” (76-100%). Linear mixed models were applied for preliminary effectiveness analyses as per intention-to-treat. ClinicalTrials.gov study identifier: NCT02764346.
Results: Adolescents (N=60) were recruited between June 2017 and April 2019. See Figure 1 for CONSORT diagram. 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. See Figure 2 for observed changes in pain intensity outcomes. There were no significant changes in activity limitations or HRQL.
Conclusion: The iCanCope pilot RCT was feasible to implement in a paediatric rheumatology setting. Both apps were deployed successfully, with high acceptability, and 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.
The post A Pilot Randomized Controlled Trial of the iCanCope Pain Self-management Application for Adolescents with Juvenile Idiopathic Arthritis appeared first on ACR Meeting Abstracts.