Development of an Evidence-based Digital Support for Sustainable Return to Work for Persons with Chronic Pain and their Employers: A User-centered Agile Design Approach (Preprint)

Abstract

Persons with chronic pain experience a lack of support after completing rehabilitation and the responsibility for the return-to-work (RTW) process is taken over by the employer. Additionally, the employers describe not knowing how to support their employees. For example, some employers wanted more information how their employees’ chronic pain will affect their work status. Smartphone apps have been increasingly used for self-management, but there is a lack of available eHealth apps providing evidence-based digital support for persons with chronic pain and their employers when they RTW.

To describe the development of an evidence-based digital support for sustainable return-to-work for persons with chronic pain and their employers (SWEPPE).

A user-centered agile design (UCD) approach was applied. The multidisciplinary project team consisted of health care researchers, a user representative, and a software team. Two reference groups of seven persons with chronic pain and four employers participated in the development process and usability testing. Mixed methods were used for collecting early input and feedback from the reference groups throughout the process. The design was revised using feedback from the reference groups. The content of SWEPPE was developed based on existing evidence and input from the reference groups.

The reference groups identified the following as important characteristics to include in SWEPPE: keeping users motivated; tracking health status and work situation; and following progress. SWEPPE was developed as a smartphone application for the persons with chronic pain and a web application for their employers. SWEPPE consists of six modules: the action plan, daily self-rating, self-monitoring graphs, the coach, the library, and shared information with the employer. The employers found the following functions in SWEPPE to be the most useful: employees’ goals related to return-to-work; barriers to RTW; support wanted from the employer and the ability to follow employees’ progress. The persons with chronic pain found the following functions in SWEPPE to be the most useful: setting a goal related to RTW; identifying barriers and strategies; and self-monitoring. Usability testing revealed that SWEPPE was safe, useful (i.e., provided relevant information), logical, and easy to use with an appealing interface.

This study reports the development of an evidence-based digital support application for persons with chronic pain and their employers. SWEPPE fulfilled the need of support after an Interdisciplinary Pain Rehabilitation Program with useful functions such as setting a goal related to RTW, identification of barriers and strategies for RTW, self-monitoring, and sharing information between employee and employer. The UCD’s agile design approach contributed to creating SWEPPE as a relevant and easy to use eHealth intervention. Further studies are needed to examine the effectiveness of SWEPPE in a clinical setting.