E-Tailored Pain Management Support for Dementia Family Caregivers: Feasibility of the PACE-app

This randomized controlled trial will assess the feasibility, usability, and preliminary efficacy of the Pain Control Enhancement App (PACE-app), a web-based intervention designed to support family caregivers of persons with dementia in managing pain. The trial will also explore mechanisms through which the PACE-app may affect caregiver and care recipient outcomes.

Uncontrolled pain is common in people with dementia and presents unique challenges for caregivers, particularly those with limited access to specialized healthcare services. Family caregivers often lack adequate knowledge, skills, and support to manage pain effectively, contributing to suboptimal outcomes for both caregivers and care recipients.

The PACE-app provides tailored, technology-based pain management support that includes:

Screening of caregiver-specific challenges in pain management;

Personalized pain management strategies based on the screening results;

Communication tools to facilitate interactions with healthcare providers;

A digital pain diary for tracking care recipients' pain experiences.

A total of 60 family caregivers of people with dementia and chronic pain will be randomized 1:1 to either the PACE-app intervention group or a usual-care control group. Participants in the intervention arm will use the app for 1 month and complete outcome assessments at baseline, 1 month (post-intervention), and 2 months (follow-up). Participants in the control arm will continue their usual caregiving practices and complete assessments on the same schedule.

Primary outcomes include feasibility (recruitment, retention, adherence to study protocol) and acceptability (measured by app usage analytics and qualitative interviews). Secondary outcomes include changes in caregiver self-efficacy in pain management, adherence to prescribed pain treatments, caregiver burden, stress, depression, and communication with healthcare providers. The study will also examine potential mediators (caregiver knowledge, communication) and moderators (caregiver characteristics, dementia severity, caregiving relationship) of intervention effects.

Additionally, the study will explore whether improvements in caregiver outcomes are associated with better outcomes for care recipients, such as reduced pain intensity and fewer urgent care visits related to pain.

Data collected will inform refinement of the PACE-app and guide the design of a future large-scale efficacy trial.

Inclusion criteria

• Be a primary caregiver - (a family member, relative, or friend) of a person with dementia (or cognitive impairment) and chronic pain (lasting >3 months)'
• Be responsible for managing the care recipient's pain and pain treatments (including interpreting verbal or non-verbal pain communication).
• Be age 18 - 100.
• Be able to read and speak English.
• Have regular access to an electronic device (tablet, laptop, or computer) with internet connectivity (for using the app and participating in data collection).
• Be accessible by phone or email to schedule meetings.
• Be willing to commit to the full study duration and protocol.

Exclusion criteria

• Currently participating in another research study that could interfere with this intervention.