Background
Breast cancer is the most common cancer in women, with 2.3 million cases globally in 2022. While survivorship is increasing, many women experience persistent post-surgical pain (PPSP)—the most frequent long-term complication of surgery—linked to inadequate acute pain management. Supported self-management and personalised follow-up are recommended. ePainQ, a web-based intervention, was co-developed using a mixed-methods approach to capture patient-reported symptoms and deliver tailored self-management advice, integrated into electronic patient records.
Methods
ePainQ comprises an informational website and a symptom questionnaire on pain, swelling, function, and quality of life, which provides personalised feedback based in self-reporting. A non-randomised feasibility study assessed acceptability, usability, and perceived usefulness. Participants chose usual care or ePainQ plus usual care. Data were collected at baseline, 2 weeks, 3 and 9 months post-operatively. Outcome measures included EORTC QLQ-C30/BR23, EQ-5D, HADS, BPI, and Patient Activation Measure.
Results
Sixty-nine patients were recruited (60 intervention, 9 cohort; mean age 57.7 years). Recruitment rate was 63%, with 89.6% engagement. All completed baseline and 2-week follow-up; 13 passive withdrawals occurred by 9 months. Of those completing usability scales, 97.5% found ePainQ easy to use, 95% required no technical support, and 90% felt confident using it. Fourteen semi-structured interviews revealed ePainQ was supportive and improved pain management understanding. HCPs valued integration into clinical records. Data suggested potential for reducing acute pain and anxiety, warranting further testing.
Conclusion and Clinical Implications
ePainQ was co-designed to meet patient-identified needs and was found to be acceptable, usable, and beneficial. All progression criteria for a phase III RCT were met. ePainQ is now being evaluated in an NIHR RfPB-funded multi-site pilot trial to assess its operability and transferability across NHS Trusts serving populations with diverse socio-demographic, economic, and ethnic backgrounds. Findings highlight the potential of nurse-led digital interventions to enhance recovery and inform future NHS policy and practice.