Barriers and facilitators of engagement with app-based self-management in chronic pain patients

Objectives: This study aimed to identify key barriers and facilitators to engaging with app-based self-management strategies among chronic pain patients. Design and method: Semi-structured individual interviews with 24 chronic pain patients were conducted. A 32-item interview schedule was created informed by previous research pertaining to digital technology uptake and the Capability, Opportunity, Motivation and Behaviour Model (COM-B, Michie et al., 2011). Transcripts were transcribed verbatim and analysed using reflexive thematic analysis. Themes were mapped onto the COM-B model to identify key barriers and facilitators to engagement and highlight necessary behavioural targets for intervention design and implementation. Results: Results indicated that barriers and facilitators aligned with Psychological Capability, Physical Capability, Physical Opportunity, Social Opportunity and Reflective Motivation. Barriers reflected: (1) Impact of pain and ability to engage; (2) Cognitive load; (3) Information access; (4) Financial; (5) Self-efficacy and (6) Individual differences. Whereas facilitators were reflective of: (7) Connection with like-minded others; (8) Improved pain awareness and autonomy and (9) Accessibility. Automatic Motivation was not represented in the data. Conclusion: This study provides insight into perceived barriers and facilitators to engaging with app-based self-management amongst chronic pain patients. Employing COM-B model mapping facilitated the identification of key behavioural components that influence uptake and utilisation of self-management strategies via digital interventions, providing a foundation for theoretically underpinned intervention development and implementation.