# Systematic evaluation of commercially available pain‐management mHealth apps for chronic pain in the United Kingdom

## TL;DR

This study evaluates the quality and features of pain management apps in the UK, finding they are moderately good but lack personalization and key behavior change techniques.

## Contribution

The paper provides a systematic evaluation of pain apps in the UK, highlighting gaps in quality and adaptive features.

## Key findings

- Most apps scored moderate quality with a mean MARS score of 3.03.
- Common behavior change techniques included self-monitoring and instruction.
- Adaptive features like decision points and tailoring variables were rare.

## Abstract

Self‐management is central in chronic pain care, and mobile health (mHealth) applications (apps) offer scalable tools to support symptom monitoring and management. Although promising, these apps vary in quality, adaptability, and integration of evidence‐based behaviour change techniques (BCTs). Many remain unregulated and under‐evaluated, leaving their benefits for pain management unclear. We systematically evaluated the quality of commercially available pain management apps in the United Kingdom and examined the prevalence of pain‐related BCTs and adaptive features.

Freely available English‐language apps from the ‘Health and Fitness’ or ‘Medical’ categories in the Apple® and Google Play® stores were screened and assessed for quality using the Mobile App Rating Scale (MARS; 1 = inadequate, 5 = excellent) and coded for BCTs and adaptive features.

Twenty‐three apps were included, with a mean MARS score of 3.03 (range = 1.8–4.6). Five scored >4.0, while 39% scored 3.0–3.9, indicating moderate quality. Apps included a mean of 3.3 BCTs, most commonly self‐monitoring (87%), instruction (61%), and behaviour–health links (52%). Social support (13%) and goal setting (17%) were rare. An average of 2.3 adaptive mechanisms were identified, with proximal outcomes in all apps and intervention options in 70%, but decision points and tailoring variables were infrequent.

Commercially available pain apps in the United Kingdom are generally of moderate quality, with limited integration of social, goal‐setting, and adaptive features. Greater personalization is needed to strengthen engagement and clinical impact in digital pain self‐management.