MOBILE application engagement may predict clinically meaningful pain reduction for adults with chronic pain and hazardous drinking.
What This Pilot Study Evaluated
Evidence based psychological care for chronic pain can be difficult to access in primary care. Researchers therefore examined whether Mobile health (mHealth) engagement behaviors within an eight-week program were linked to later pain outcomes in adults with chronic pain who also engaged in hazardous drinking.
This secondary analysis pooled participants (N=39) from two pilot trials of the same intervention. The team tracked multiple engagement indices, including skills library access, skill reviews, homework surveys completed, videos opened and completed, and the frequency of instant messaging coaching sessions.
Pain was measured using the Pain, Enjoyment of Life, and General Activity (PEG) scale at baseline and again 12 to 16 weeks later.
Mobile App Engagement Behaviors That Matter
Across analyses controlling for trial, several engagement components were most closely associated with a greater likelihood of reaching a clinically meaningful improvement, defined as at least a 30% reduction in pain.
Higher levels of skill reviews, greater completion of homework surveys, and completing more videos emerged as the engagement indices most strongly tied to improved pain outcomes. Among these, videos completed stood out as a particularly informative marker of benefit, suggesting that depth of participation, not simply logging in, may be what translates into symptom change.
In contrast, the frequency of instant messaging coaching sessions did not appear to be linked with pain outcomes in this sample.
Why the Findings May Matter in Practice
For clinicians considering digital supports for chronic pain in patients with hazardous drinking, the results point toward measurable in app behaviors that may help identify who is benefiting and where engagement support might be targeted. The authors suggest that tracking and potentially enhancing specific engagement indices could strengthen clinical impact, aligning with broader interest in digital therapeutics that aim to deliver evidence-based care at scale.
Because this was a secondary analysis of small pilot trials, the findings should be interpreted as signals for further testing rather than proof of causality. Still, the study offers practical clues about which engagement metrics may be most worth monitoring when implementing mobile interventions for chronic pain in real world primary care settings.
Reference: Bernier L et al. Mobile App Engagement and Pain Outcomes Among Primary Care Chronic Pain Patients Who Engage in Hazardous Drinking: A Pilot Study. J Clin Psychol Med Settings. 2026;doi:10.1007/s10880-026-10127-2.
