A Digital Video and Text Messaging Intervention to Support People with Chronic Pain During Opioid Tapering: Content Development Using Co-Design (Preprint)

Abstract

People living with chronic pain report that tapering prescribed opioids is challenging even with multidisciplinary healthcare and more support is needed. Consumers have agreed that a mobile health (mHealth) support which provides informational and socioemotional support could be an acceptable support for tapering and may improve tapering self-efficacy.

Using a co-design approach we developed content for a mHealth intervention. This study collected consumer and clinician feedback, aiming to evaluate and improve the mHealth content and design.

Participants were 12 consumers and 12 clinicians who were asked to evaluate a draft video script and 90 SMS text messages. Each evaluator rated the Appropriateness (both groups) and Likely Usefulness (consumers only) or Likely Effectiveness (clinicians only) of the script and 15 texts, so that every text was reviewed by 2 consumers and 2 clinicians on a 5-point Likert-type scale from Totally Disagree to Totally Agree. All reviewers were also invited to provide open text feedback about the script and text messages.

On average, Consumers ‘Agreed’ the script and text messages were ‘Appropriate and Likely to be Useful’. On average, Clinicians ‘Agreed’ the script and text messages were ‘Appropriate and Likely to be Effective’. Eighty-three percent (10 out of 12) of consumers and 58% (7 out of 12) of clinicians provided feedback on the script. For the text messages, an acceptability cut-off was set using the survey responses. Consumer ratings indicated 77% of texts were above the cut-off value. Clinician ratings indicated 82% of texts were above the cut-off value. Of 90 text messages, 41 received comments from consumers and 28 received comments from clinicians which informed revisions. Ten consumers and eight clinicians provided general feedback on the text messages. The revised script was developed into a short video and text messages were edited based on survey responses and open text feedback.

This study describes the co-design of a 28-day mHealth intervention which includes a 10-minute video containing informational content and testimonials from consumers with opioid tapering experience and 56 SMS text messages (for two unique messages to be sent each day– one in the morning and one in the afternoon – for 28 days). The intervention aims to provide patients with chronic pain with informational and emotional support to improve their self-efficacy for tapering prescription opioids.