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Objectives
Given the significant health burden of chronic pain and the valuable health insights that daily behavioral patterns can provide, we aimed to better understand the underlying causes of pain, functional impact of pain, and behavioral predictors of breakthrough pain utilizing self-reported survey data and behavioral data (e.g., step and sleep patterns) from activity trackers. In this initial analysis, we explored the baseline prevalence of pain management strategies (including opioid use and digital health tools) and activity tracker use.

Methods
Individuals with moderate to severe chronic pain (case) and those without chronic pain (control) were eligible to enroll in a currently ongoing, prospective, 1-year, virtual study. Participants completed daily and monthly surveys about their pain and overall health. Activity trackers or health/fitness apps could also be connected to the study. We report baseline findings for all enrolled participants, and behavioral metrics from participants with ≥30 days of behavioral data.

Results
We enrolled 10,036 individuals (5,832 chronic pain/4,204 no chronic pain) within a 9-month period. On average, individuals with chronic pain walked 6,392 steps daily and spent 6.8 hours in bed per day compared to 8,594 steps and 6.7 hours in bed per day for those without chronic pain (*all p-values < 0.0001 based on non-parametric Mann-Whitney U test). Among chronic pain sufferers, current opioid use and digital app use to manage pain was 26% and 44%, respectively. Differences in pain management strategies were noted between sub-cohorts of individuals with various health conditions (e.g., migraines, fibromyalgia, etc.). Effectiveness of these pain management strategies were rated as 3.1 and 1.5, respectively, on a scale from 0-5 (not at all to extremely helpful in managing chronic pain).

Conclusion
This large-scale study can provide significant insights about chronic pain and its overall management. Additional analyses will explore the feasibility of developing digital biomarkers for pain and overall health.

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