Mobile App with Contingency Management Improves Pain Outcomes in Adults with NF1

A randomized clinical trial evaluated 108 adults with Neurofibromatosis Type 1 (NF1) and chronic pain. Participants were assigned to one of three groups: the iCanCope mobile application (iCC-NF), iCanCope plus contingency management (iCC-NF + CM), or treatment as usual (control). The study followed participants for 2 months, though the primary outcome was not specified.

Compared to the control group, the iCC-NF + CM group showed statistically significant improvements across several secondary pain-related outcomes. Effect sizes were moderate to large: pain interference (d = 0.815, p = 0.005), pain self-efficacy (d = 0.718, p = 0.009), pain inflexibility (d = 0.629, p = 0.026), and chronic pain acceptance (d = 0.653, p = 0.036). The study did not report absolute numbers or event rates for these outcomes. No significant differences were found between the iCC-NF + CM and iCC-NF groups.

Safety and tolerability data, including adverse events and discontinuations, were not reported. The study did not specify a primary outcome, and the evidence remains preliminary with a 2-month follow-up. The randomized design suggests possible causality for comparisons with the control group. For clinicians, this provides initial data on a digital auxiliary treatment option for chronic pain in NF1, but the lack of safety information and longer-term outcomes warrants caution.