Andrea Enzinger, MD
Health Services Researcher, Dana-Farber
Assistant Professor of Medicine, Harvard Medical School
Pain remains one of the most persistent—and often under-addressed—challenges for patients with advanced cancer. Clinic visits offer opportunities to adjust medications or troubleshoot symptoms, but most pain management happens at home, between appointments, when patients may struggle with complex regimens or rapidly changing symptoms. Recognizing this gap, Andrea Enzinger, MD, a health services researcher at Dana-Farber Cancer Institute and an assistant professor of medicine at Harvard Medical School, set out to build a more proactive, connected approach to pain care.
Her team developed MyPainPal, a digital health platform designed to extend supportive pain care beyond the clinic. The system links a clinician-facing web portal with a patient-facing app that patients use to track symptoms, record medication use, receive tailored education, and access behavioral support. Now being evaluated in pilot studies, MyPainPal reflects a broader effort to create cancer care that anticipates patients’ needs, personalizes support, and focuses on how patients actually experience pain.
From Reactive to Proactive Pain Care
In routine practice, pain care can be fragmented and reactive. Patients may leave a visit with a new medication plan, only to encounter confusion, intolerable side effects, or uncontrolled pain days later.
We wanted to go beyond just asking [patients] about pain levels. We wanted to understand what patients were experiencing so we could provide tailored education and support.
Andrea Enzinger, MD
“When symptoms escalate, patients often worry about whether they should contact their care team and frequently delay calling until symptoms are severe and urgent,” Enzinger explains.
MyPainPal aims to replace this reactive cycle with continuous, real-time support. By collecting information about medication use, effectiveness, and emerging symptoms or barriers, the platform gives clinicians a clearer picture of patients’ pain trajectories between visits.
“We wanted to go beyond just asking about pain levels,” she says. “We wanted to understand what patients were experiencing so we could provide tailored education and support.”
Designed for Real Life
At the center of this approach, the MyPainPal app gives patients an easy, intuitive way to record their experiences through short, simple digital check-ins. The design intentionally avoids the complexity of many commercial wellness apps, emphasizing clarity and clinical relevance, and is well suited for older adults who may be less comfortable with smartphone technology.
Information entered into the app flows directly to the clinician portal, allowing care teams to identify trends, reach out to patients experiencing troublesome symptoms, and adjust medications or other management strategies.
Safety features are embedded throughout the system. When patients report symptoms that exceed predefined thresholds, MyPainPal automatically advises them to contact their care team and provides a one-tap phone link. Alerts are also sent to clinical teams via secure email and the electronic health record gateway, supporting timely follow-up when symptoms require attention.
A Collaborative Effort
Building a tool suited to real-world oncology care required close collaboration across Dana-Farber. The Digital Innovation team led software development and ensured smooth electronic health record integration, while experts in nursing, pain psychology, behavioral science, pharmacy, quality improvement, and palliative care shaped the educational and clinical components. A patient stakeholder panel, supported by Dana-Farber’s Patient and Family Advisory Council (PFAC), provided ongoing feedback to ensure the tool reflects real patient needs and experiences.
Early Findings
Pilot testing of the initial MyPainPal app showed strong feasibility and acceptability among patients with advanced cancer. For instance, a 2021 paper in Support Cancer Care described a mixed-methods pilot study in which patients used the app to track pain and medications between visits, demonstrating high engagement, usability, and perceived benefit for communication and self-management. Participants reported feeling more supported in managing their pain and valued the clarity and usefulness of the educational content. Early indications of clinical impact included improved symptom tracking and more consistent medication adherence.
A development paper and early usability evaluation of MyPainPal, published in JMIR Formative Research in 2025, also found that patients viewed the app as easy to use and highly acceptable—reinforcing the potential of digital health tools to support symptom management in advanced cancer.
Support for This Approach
Funding for MyPainPal includes support from the National Cancer Institute (NCI), the National Institute of Nursing Research (NINR), and the Fund for Innovation in Cancer Informatics, a philanthropic initiative that awards competitive grants for cancer informatics research. Additional support came from Dana-Farber’s Medical Oncology Grant Program, the Oppenheimer Fund for Palliative Care, the McGraw Patterson Fund, and Friends of Dana-Farber.
Expanding Support with Mindfulness
Enzinger’s team recently secured additional NCI funding to incorporate a mindfulness-based pain management component into the app. This module features daily meditations and brief video introductions tailored for patients with advanced cancer.
To keep practices accessible, most of the meditations last eight to ten minutes—long enough to be meaningful but short enough to fit into demanding treatment schedules. The content is especially helpful for patients experiencing pain catastrophizing, a pattern in which pain triggers distressing thoughts that intensify suffering. The goal is to strengthen coping skills, not to minimize the seriousness of patients’ pain. They also included comprehensive guidance on sleep hygiene, pain coping strategies, and relaxation techniques.
In addition, Enzinger also worked with Desiree Azizoddin, PsyD, a pain psychologist at Dana-Farber, to add evidence-based cognitive behavioral therapy for pain (pain-CBT).
“These treatments are often siloed, yet patients report better self-management when they are seamlessly integrated,” Azizoddin says. She adds that the goal is holistic support that unites the medical, emotional, and psychological aspects of high-quality pain care,”
These resources are delivered through brief animated videos, written text, and illustrations drawn from evidence-based cognitive behavioral therapy for pain (pain-CBT). Patients report that the app has been particularly helpful in building self-management skills to improve chronic cancer pain.
Looking Ahead
Enzinger notes that MyPainPal was designed with flexibility in mind. Clinicians and researchers can tailor features to individual needs—prompting more detailed medication tracking for patients with unstable pain or emphasizing mindfulness resources for those experiencing emotional distress. This adaptability positions the platform for future integration into clinical workflows at Dana-Farber and beyond.
“We recently finished rebuilding the system and integrating it with the electronic health record, which was a huge lift,” Enzinger says. “We’re now preparing to pilot both the platform and the mindfulness module among hospitalized patients with cancer pain and use it to ease challenges during the hospital-to-home transition.”
Ultimately, she hopes MyPainPal helps patients feel more supported and less alone—and that it can scale beyond Dana-Farber so patients everywhere can benefit.
“I really hope that this makes patients feel less isolated in their pain,” she says. “Not just in the clinic, but at home—when it matters most.”
Team Members
Desiree Azizoddin, PsyD
Assistant Professor, Department of Supportive Oncology, Dana-Farber
