Dolodoc, a mobile application for the self-management of chronic pain: Acceptability and usability study

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Abstract
Background: Approximately 19% of adults in Europe are affected by chronic pain, which reduces quality of life. Pain management apps (mHealth) offer a promising solution for self-management, but users engagement and adherence can be a limitation to their clinical impact. User experience design and studies play an important role in optimizing usability and long-term adoption of digital health interventions. Objective: This study aims to evaluate the user experience of Dolodoc, a mobile application for chronic pain self-management, using a mixed-methods approach that evaluates acceptability through a content quality survey and examines usability by analyzing overall usage patterns. Methods: A cross-sectional acceptability study was conducted among chronic pain patients recruited from the Geneva University Hospitals pain center and through snowball sampling. Participants rated 84 evidence-based self-management strategies using a five-point Likert scale based on 5 acceptability criterias: understandability, motivation, feasibility, relevance, and alignment with the related quality-of-life dimension. Usability was assessed through usage metrics that were collected over six months using Piwik PRO analytics to observe the usage behaviors of real-world Dolodoc users. Results: In the acceptability study, a total of 33 participants rated the self-management strategies positively across all dimensions. On a scale from −2 to 2, the strategies were well understood (mean = 1,47), motivational (1.12), feasible(1.01), relevant (0.99), and aligned with the dimensions (1.33). The usability study demonstrated that 60% of patients used Dolodoc only once, indicating that long-term adherence remains a challenge. Within Dolodoc, pain tracking, useful links and medication logging were the most actively used features. Discussion: This study highlights the gap between acceptability and long-term adherence to mHealth solutions. Improving personalization and accessibility could increase user engagement and long-term adherence. Future iterations of the app should incorporate tailored interventions and real-time feedback mechanisms. In addition, taking advantage of a digital navigation follow-up could facilitate user adoption and sustained engagement.

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