Technologies 2022, 10, 25. https://doi.org/10.3390/technologies10010025 www.mdpi.com/journal/technologies Article User-Centric Design Methodology for mHealth Apps. The PainApp Paradigm for Chronic Pain Yiannis Koumpouros Department of Public and Community Health, University of West Attica, 11521 Athens, Greece; ykoump@uniwa.gr; Tel.: +30-6944254112 Abstract: The paper presents a user-centric methodology in order to design successful mobile health (mHealth) applications. In addition to the theoretical background, such an example is presented with an application targeting chronic pain. The pain domain was decided due to its significance in many aspects: its complexity, dispersion in the population, the financial burden it causes, etc. The paper presents a step-by-step plan in order to build mobile health applications. Participatory design and interdisciplinarity are only some of the critical issues towards the desired result. In the given example (development of the PainApp), a participatory design was followed with a team of seven- teen stakeholders that drove the design and development phases. Three physicians, one behavioral scientist, three IT and UX experts, and ten patients collaborated together to develop the final solu- tion. The several features implemented in the PainApp solution are presented in details. The appli- cation is threefold: it supports the management, reporting, and treatment effectiveness monitoring. The paper is giving details on the methodological approach while presenting insights on the actual plan and the steps followed for having a patient-centric solution. Key success factors and barriers to mobile health applications that support the need for such an approach are also presented. Keywords: mHealth; health; pain; mobile; assessment; evaluation; usability; subjective assessment; patient-centered design; mobile health 1. Introduction Chronic pain is defined as pain that lasts or recurs for more than 3 to 6 months [1]. The pain extends beyond the expected period of healing and can involve complex psy- chological and social factors. The International Association for the Study of Pain (IASP) define it as an unpleasant sensory and emotional experience associated with, or resem- bling that is associated with, actual or potential tissue damage [2]. According to several studies, around 30% of the global population suffer from chronic pain. Chronic pain af- fects many aspects of a person’s life and is highly correlated to increased medical costs and reduced quality of life. The main causes of pain are spinal pain, arthritis, cancer pain, headaches, fibromyalgia, injuries, and neurogenic pain, making the etiology of pain a very complex issue. Depression, absence from work, lack of social life or even suicidal thoughts are only some of the consequences of pain. Other symptoms include anxiety, fatigue, in- somnia, and mood swings. Its significance is revealed by the fact that back and neck pain are among the top five causes of years lived with disability [3]. More than 500 million days have been missed in Europe, according to the European Pain Federation, due to chronic pain issues. This equals to more than EUR 300 billion or 1.5% to 3% of the GDP [4]. The World Health Organization, in 2019, incorporated chronic pain in the eleventh version of the International Classification of Diseases (ICD-11) [5]. In the United States of America, the prevalence of chronic pain exceeded the one of diabetes, cancer, and heart disease combined. Recent statistics show that chronic pain is more prev- alent among women (e.g., 85% of chronic migraine sufferers are women). Citation: Koumpouros, Y. User-Centric Design Methodology for mHealth Apps. The PainApp Paradigm for Chronic Pain. Technologies 2022, 10, 25. https://doi.org/10.3390/ technologies10010025 Academic Editor: Pedro Antonio Gutiérrez Received: 19 December 2021 Accepted:28 January 2022 Published: 31 January 2022 Publisher’s Note: MDPI stays neu- tral with regard to jurisdictional claims in published maps and institu- tional affiliations. Copyright: © 2022 by the author. Li- censee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and con- ditions of the Creative Commons At- tribution (CC BY) license (https://cre- ativecommons.org/licenses/by/4.0/).