Daily perceived change among patients with chronic pain: influence of sociodemographic, clinical, and psychological characteristics

Pain Rep. 2026 Jun 1;11(4):e1449. doi: 10.1097/PR9.0000000000001449. eCollection 2026 Aug.

ABSTRACT

OBJECTIVES: Clinicians who treat patients with chronic pain often rely on self-report impressions of how things have changed since last seen. The aim of this study was to examine factors that contributed to perceived day-to-day impressions of change among these patients.

METHODS: Two hundred twenty-two subjects (N = 222) with chronic pain used a smartphone pain application (app) as part of previous clinical trials. All participants completed baseline questionnaires and monitored their daily condition on the app for up to 30 days. They reported their progress every day by rating their pain intensity, activity interference, sleep disturbances, and negative affect and answered whether they perceived their overall condition as having improved or gotten worse on a 0 to 10 visual analogue scale.

RESULTS: Multilevel models using lagged analyses showed that current sense of change was significantly influenced by ratings of pain intensity, sleep disturbances, activity interference, and depression and anxiety the day before the rating (P < 0.001). Multilevel logistic regression analyses further showed that previous day sleep problems and negative mood had the greatest influence on perceived worsening the following day (P < 0.05). Those with high pain catastrophizing, younger age, and positive opioid use status were most prone to report their condition worsening.

CONCLUSION: This study highlights the importance of inquiring not only about pain intensity but also about sleep disturbances and mood in understanding changes between clinic visits. Clinicians with access to pain app data have increased opportunities to accurately identify those individuals who are most prone to report perceived worsening.

PMID:42238974 | PMC:PMC13229476 | DOI:10.1097/PR9.0000000000001449