Computerized PAINRelievelt for Adult Sickle Cell Disease

成人镰状细胞病的计算机化疼痛缓解

• 批准号: 7144113
• 负责人: DIANA J WILKIE
• 金额: $ 74.74万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7144113
• 关键词: analgesia; analgesics; behavioral /social science research tag; chemotherapy; clinical research; computer assisted patient care; coping; education evaluation /planning; emergency health services; health education; human subject; human therapy evaluation; interactive multimedia; outcomes research; pain; pain threshold; patient oriented research; sickle cell anemia; sickle cell crisis; therapy compliance

DESCRIPTION (provided by applicant): Unrelieved sickle cell disease (SC) pain is a major health problem attributed in part to pain assessment difficulties and to lack of knowledge about analgesics known to be effective for pain control. We propose a two-phase longitudinal study testing three valid and reliable touch screen computerized tools: a) pain assessment data collection and summary report (PAINReportlt); b) multimedia patient education tailored to the patient's SC pain management misconceptions (PainUCope); and c) decision support for clinicians to prescribe algorithm-based analgesic therapies tailored to the patient's pain (PAINConsultN). Together, the three programs are known as PAINRelievelt. In the first phase of the randomized clinical trial, we will use a pre-test/post-test design in 250 patients receiving care at the DIG Sickle Cell Clinic to compare the effects of usual care and PAINReportlt/PainUCope on a) patient outcomes (misconceptions about pain, analgesic adherence, and pain intensity); and b) an outpatient provider outcome (pain documentation). We hypothesize that, three months after the intervention, the computerized PAINReportlt/PainUCope group will have decreased misconceptions and pain intensity and increased analgesic adherence, pain documentation in the medical record. In the second phase, we will use a longitudinal, repeated-measures design in the same 250 sickle cell patients to compare the effects of randomly assigning their attending ED or inpatient physicians to usual care or PAINReportlt/PAINConsultN. We will compare usual care and PAINReportlt/PAINConsultN for long-term effects on a) patient outcome (pain episodes) in 250 patients at risk for ED visits or hospitalization with painful SC crisis; b) ED or inpatient provider outcomes (pain documentation; appropriateness of prescribed analgesics) in 34 UIC ED and inpatient physicians; and c) system outcomes (number of ED visits and hospital days for painful SC crisis). We hypothesize that, two years after the intervention is implemented, the PAINReportlt/PAINConsultN group will report: a) decreased pain episodes; b) increased pain documentation in the medical record and number of appropriate analgesic prescriptions; and c) decreased number of ED visits and hospital days. Findings will guide large-scale implementation of this innovation in SC care throughout the USA.

描述（由申请人提供）：不脱落的镰状细胞疾病（SC）疼痛是一个主要的健康问题，部分原因是疼痛评估困难以及对已知可有效控制疼痛的镇痛学知识的缺乏知识。我们提出了一项两阶段纵向研究，测试三种有效且可靠的触摸屏计算机化工具：a）疼痛评估数据收集和摘要报告（PainReportlt）； b）针对患者的SC疼痛管理误解（Painucope）量身定制的多媒体患者教育； c）为临床医生开出基于算法的镇痛疗法的决策支持（Painconsultn）。这三个程序一起被称为Painrelievelt。在随机临床试验的第一阶段中，我们将在250名在Dig Sickle Cell Clinic接受护理的患者中使用预测试/测试后设计，以比较通常的护理和Painreportlt/Painucope对A）对患者结果的影响（对疼痛，镇痛性依从性和疼痛强度的误解）； b）门诊提供者的结果（疼痛文档）。我们假设，干预后三个月，计算机化的Painreportlt/Painucope组将减少误解和疼痛强度，镇痛依从性增加，病历中的疼痛记录。在第二阶段，我们将在相同的250个镰状细胞患者中使用纵向重复测量设计，以比较随机分配其会议或住院医生与通常的护理或Painreeportlt/Painconsultn的效果。我们将比较常规护理和PAINREPORTLT/PAINCONSULTN，以便在250名患有ED访问或住院的患者中对患者结局（疼痛发作）的长期影响（疼痛发作）； b）在34名和住院医生中的ED或住院提供者的结果（疼痛文献；处方镇痛药的适当性）； c）系统结果（急性SC危机的ED访问和医院日数）。我们假设，在实施干预后两年，Painreportlt/Painconsultn组将报告：a）减少疼痛发作； b）病历中的疼痛记录增加和适当的镇痛处方数量； c）减少急诊就诊和医院的日子。调查结果将指导整个美国的SC Care的大规模实施。