title: Pain buddy: A novel use of m-health in the management of children's cancer pain.
abstract: Over 12,000 children are diagnosed with cancer every year in the United States. In addition to symptoms associated with their disease, children undergoing chemotherapy frequently experience significant pain, which is unfortunately often undertreated. The field of m-Health offers an innovative avenue for pain assessment and intervention in the home setting. The current study describes the development and initial evaluation of a tablet-based program, Pain Buddy, aimed to enhance pain management and foster improved quality of life in children ages 8-18 years undergoing cancer treatment.
  
  
  
  An animated avatar-based tablet application was developed using state-of-the-art software. Key aspects of Pain Buddy include daily pain and symptom diaries completed by children, remote monitoring of symptoms by uploading patient's data through internet to a cloud server, cognitive and behavioral skills training, interactive three-dimensional avatars that guide children through the program, and an incentive system to motivate engagement. Twelve children between the ages of 8 and 18 participated in a pilot study of Pain Buddy.
  
  
  
  Children were highly satisfied with the program. Pain and appetite disturbances were most frequently endorsed. Symptom trigger alerts to outside providers were largely related to clinically significant pain. Children infrequently used analgesics, and reported using some non-pharmacological pain management strategies.
  
  
  
  Pain Buddy appears to be a promising tool to improve pain and symptom management in children undergoing cancer treatment. Results from the current study will inform future improvements to Pain Buddy, in preparation for a randomized controlled trial to assess the efficacy of this innovative treatment.
authors.affiliation: Department of Anesthesiology & Perioperative Care, University of California-Irvine, 505 S. Main St., Suite 940, Orange, CA 92868, USA; Department of Pediatric Psychology, CHOC Children's Hospital, 1201 W. La Veta Avenue, Orange, CA 92868, USA; UCI Center on Stress & Health, School of Medicine, University of California-Irvine, 505 S. Main St., Suite 940, Orange, CA 92868, USA. Electronic address: mfortier@uci.edu.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fortier
authors.affiliation: Department of Pediatric Psychology, CHOC Children's Hospital, 1201 W. La Veta Avenue, Orange, CA 92868, USA.
authors.forename: Winnie W
authors.initials: WW
authors.lastname: Chung
authors.affiliation: Department of Anesthesiology & Perioperative Care, University of California-Irvine, 505 S. Main St., Suite 940, Orange, CA 92868, USA; UCI Center on Stress & Health, School of Medicine, University of California-Irvine, 505 S. Main St., Suite 940, Orange, CA 92868, USA.
authors.forename: Ariana
authors.initials: A
authors.lastname: Martinez
authors.affiliation: California Institute of Telecommunications and Information Technology (Calit2), University of California-Irvine, Calit2 Administration, 4100 Calit2 Building, Irvine, CA 92697-2800, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Gago-Masague
authors.affiliation: Chao Family Comprehensive Cancer Center, University of California-Irvine, Building 23, 101 The City Drive South, Orange, CA 92868, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Sender
mesh_terms: D000293:Adolescent; D000072716:Cancer Pain / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D063731:Mobile Applications; D059408:Pain Management / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D017216:Telemedicine / Q000379:methods*
keywords: Cancer pain; Health information technology; Pediatric cancer; Quality of life; Symptom management