INTRODUCTION:
Technology can support safe and effective management of cancer pain in the home environment.  We tested a package of wearable and environmental sensors, Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C) to: 1) understand the contextual factors that predict and influence the experience of pain; and 2) explore the dyadic effect between patient and caregiver experiences related to cancer pain.

METHODS: 
Patient-family caregiver dyads were recruited from an outpatient oncology palliative care clinic.  In Phase I, interviews explored: 1) challenges of managing cancer pain at home; 2) contextual variables relevant to cancer pain; and 3) design feedback regarding BESI-C components. Responses were analyzed using qualitative content analysis.  In Phase II, in-home BESI-C deployments explored:  1) fidelity of data capture; 2) system utilization; and 3) dyad experiences via in-person de-briefings and correlation of ground truth with recorded sensor data. 

RESULTS:
In Phase I, dyads validated: 1) pain challenges such as impact on sleep, unpredictability, and medication concerns; 2) variables that influence pain related to medication, wellness, interactions, and environment; and 3) high receptivity to the BESI-C system.  Phase II deployments iteratively addressed issues related to human-computer interaction, participant burden, and data capture. Preliminary analysis shows the ability of BESI-C to correlate activity/mobility, environmental and ecological momentary assessment data with marked pain events.

CONCLUSIONS:
Dyads are open to novel approaches to managing pain in the home. Significant potential exists for BESI-C to inform and deliver personalized interventions to patients and caregivers, particularly those in underserved areas or enrolled in home hospice programs.

EXPLORING THE FEASIBILITY AND ACCEPTABILITY OF A HOME-BASED, SMART HEALTH SENSING SYSTEM TO IMPROVE CANCER PAIN MANAGEMENT FOR PATIENTS AND CAREGIVERS