Table 3.

Selected survey results that informed design of the mobile app.

Key results from our survey of oncology healthcare providers at 4 cancer care centers in Nepal	How survey data informed design of the NAPCare PMG app
Knowledge, beliefs, and perceived barriers to cancer pain management • 95% agree it is their job/role to manage cancer pain; • 95% agree that cancer pain can be difficult, but usually can be controlled; • Shortages of morphine, codeine and tramadol were rarely reported within the past 6 months at any institution; • Key barriers to pain management included lack of palliative care/pain management training for healthcare providers and having to care for too many patients; • Most common non-pharmacological treatments included: heat/cold packs and massage.	• Providers validate cancer pain management is an important patient care issue and opioids are usually available at their institution; • App user interface designed to be quick, simple and easy to use in busy clinical setting with multiple patient interactions happening simultaneously; • Enhanced app design will include more embedded tools related to opioid dosing, pain assessment strategies, side effect management, and links to palliative care training materials • App includes both pharmacological and non-pharmacological pain management strategies.
Awareness and use of NAPCare PMG • 96% had heard of the NAPCare PMG; 84% of nurses and 56% of physicians reported they have used the NAPCare PMG.	• The NAPCare PMG are a known and respected resource. Digitizing the NAPCare PMG has significant potential to increase uptake among larger numbers of generalist oncology HCPs.
Smart phone usage and barriers • 98% have access to a smart phone; 82% use an Android smart phone; • Apps are used ‘often' or ‘very often' by nurses and physicians for clinical care	• Smart phones are ubiquitous and commonly used by both nurses and physicians in Nepal and are a viable way to implement the PMG; • We built our app for Android OS, as it is most commonly used.
Desired features of a pain mobile app • Nurses: educate patients and family members; share information/learn from other healthcare providers; understand cancer pain physiology; • Physicians: help prescribe opioid medications; help prescribe non-opioid medications; share information with/learn from other healthcare providers.	• Enhanced app functionality will prioritize: (1) tools and resources to educate patients and family members; (2) support in safe opioid and non-opioid prescribing and administration; (3) understanding cancer pain physiology; and (4) sharing information with/learning from other healthcare providers.
Outcome metrics/how we will know app is helping • PMG will be followed more consistently; healthcare providers will feel more confident prescribing/administering pain management therapies; healthcare providers will use app often; families will be less stressed; patients will be in less pain.	• Outcome effectiveness measures for the app will include data tracking regarding frequency of app use; PMG adherence; HCP confidence in prescribing/administering pain therapies; patient reports of pain and perceived patient/family distress levels.