title: Correlation of digital health use and chronic pain coping strategies.
abstract: BACKGROUND
  Digital health is an increasingly popular tool for patient engagement, having shown great success in arenas such as medication adherence, management of chronic conditions, and patient safety. Given the growth of chronic pain diagnoses, it is imperative to find new technologies to improve care for this particular population. Little research has catalogued the use of digital health in the chronic pain patient population. This manuscript's objective was to describe current patterns of digital health usage among chronic pain patients and how digital health use correlates with health care utilization and health outcomes.
  
  
  METHODS
  A cross-sectional survey was administered to patients with a self-identified chronic pain diagnosis participating in 'Patients Like Me'®(PLM), an organization that directly collects data from patients experiencing chronic health conditions, with emphasis on patient-centered outcomes and experiences interacting with the health care system. Validated measures of healthcare utilization, chronic pain management, and digital health use were adapted for the survey. Digital health was defined as the use of online sites, social media, and mobile phone applications before, during, or after healthcare utilization. Descriptive statistics, chi square tests, logistic regression, and linear regression were used as appropriate for analysis.
  
  
  RESULTS
  Among 565 respondents (mean age 51.3, 87.2% female, 45.7% publicly insured), most participants (89.5%) reported some digital health use. Females and users below the age of 50 were more likely to use multiple forms of digital health. Healthcare utilization, education level, and race/ethnicity did not correlate with digital health use. Patients using more types of digital health reported significantly higher levels of pain coping skills in the realms of social support, relaxation, and exercise.
  
  
  CONCLUSIONS
  Digital health use is common among a wide range of patients with chronic pain diagnoses. The use of multiple forms of digital health is associated with improved chronic pain coping mechanisms. Future work should explore the directional relationship between digital health tools and chronic pain coping skills, as well as which components of digital health have the most effect on chronic pain management and other patient-centered outcomes.
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Ranney
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Duarte
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
authors.forename: Janette
authors.initials: J
authors.lastname: Baird
authors.affiliation: The Miriam Hospital, Providence, RI 02906, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Patry
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA;; Department of Emergency Medicine, Boston University School of Medicine, 771 Albany Street, Room 1208, Boston, MA 02118, USA;; Inflexxion, Inc., 320 Needham St. Suite 100, Newton, MA 02464, USA.
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
keywords: adult; chronic pain; healthcare disparities; mHealth; mobile applications; psychological adaptation; web browser