Pain Assessment Interview and Clinical Advisory System

疼痛评估访谈和临床咨询系统

基本信息

批准号：
8056298
负责人：
Stephen F Butler
金额：
$ 68.88万
依托单位：
INFLEXXION, INC.
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-01 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8056298
关键词：
Academy Address Adopted Adoption Agreement Alcohol or Other Drugs use American Analgesics Attention Caring Chronic Client satisfaction Clinic Clinical Clinical Management Clinical Pathways Cognitive Complex Computers Conduct Clinical Trials Data Data Aggregation Data Analyses Development Development Plans Disease Management Documentation Electronics Environment Evaluation Flowcharts Health Health Policy Healthcare Individual Industry Intake Interview Medical Medicine Modeling Monitor Moods Opioid Outcome Pain Pain Measurement Pain management Paper Patient Monitoring Patient Self-Report Patients Pattern Persons Pharmaceutical Preparations Phase Physicians Plague Policy Maker Practice Guidelines Process Production Provider Public Health Quality of Care Quality of life Questionnaires Randomized Clinical Trials Randomized Controlled Clinical Trials Recommendation Reporting Research Resources Risk Risk Assessment Risk Management Sampling Societies Specialist Standardization Substance abuse problem Symptoms Syndrome System Technology Testing Time Visit Work chronic pain clinical care clinical practice computerized design follow-up illiteracy improved innovation interest medical specialties meetings prescription opioid pressure primary outcome programs prototype psychosocial response success tool treatment as usual usability

项目摘要

DESCRIPTION (provided by applicant): This Phase II application continues development of the Pain Assessment Interview Network - Clinical Advisory System (painCAS), a systematic and tested computer-administered assessment of chronic pain patients. Initial Assessment and Follow-up modules assess relevant health and functioning information of patients as they enter or continue treatment for chronic pain. Provider Initial and Follow-up Reports organize patient information in a convenient way that brings to the provider's attention notable health and functioning issues. The assessment includes an evaluation of risk for misuse and abuse of prescription pain medication. painCAS also generates a report specifically intended for patients. Finally, painCAS includes provider-focused tools for uploading and analyzing aggregate data for patients who have taken the painCAS assessments, as well as a Decision Support resource that can help guide treatment. Such a pain management resource would allow a physician to maximize the available time in a clinic encounter while minimizing potential adverse impacts of treatment, such as abuse or misuse of analgesics. A convergence of factors suggests the time is right for a clinical tool like the painCAS: (1) increasing pressure from healthcare policy makers and payors to systematize care, documentation, risk assessment, and prescribing; (2) public demands for adequate pain treatments; (3) public, industry, and regulator concerns about prescription medication misuse and abuse; (4) increasing acceptance of computer assessment and tools (including EMRs) in clinical settings; (5) increasing interest in clinical pathways and disease management to improve the efficiency and quality of care, and (6) an increasing recognition of the importance of understanding certain chronic conditions from a multidimensional perspective. Despite the need and several prior efforts to develop electronic pain assessments, the American Academy of Pain Medicine (AAPM) notes that no system has yet been widely adopted. Building on our prior work developing and disseminating electronic assessments as well as an innovative combination of features that add value to the system, a strong case can be made that the painCAS will be adopted. During Phase I, the groundwork was laid for a system design that will fit into the flow of clinical activities, meet important assessment and reporting needs, and provide relevant information directly to patients. Phase II will see the completion of remaining components of the assessments and design and the building of the completed painCAS system to be tested in a field trial. In Phase II, a multilevel, controlled, randomized clinical trial of patients in pain specialty clinics will test the impact of painCAS on treatment process and outcome against a painCAS assessment only condition and a treatment-as-usual condition. The tested hypotheses are that the painCAS will: 1) standardize documentation of chronic pain assessments, 2) increase the likelihood of discussion of appropriate topics and issues during the medical visit, and 3) improve the patient's satisfaction with treatment. Secondary analyses will examine the extent to which painCAS use is associated with improvement in pain functioning, mood, and misuse/abuse of medications. The proposed painCAS potentially addresses limitations of existing efforts to enhance assessment and practice in the treatment of chronic pain. PUBLIC HEALTH RELEVANCE: As society increasingly demands that medical professionals address the complex clinical presentations of patients with chronic pain, it is increasingly important that providers have the benefit of standardized computer- administered assessments along with computerized treatment recommendations. Successful development and dissemination of a comprehensive, integrated Pain Assessment Interview Network - Clinical Advisory System (painCAS) will go some distance toward enhancing assessment and treatment of chronic pain and be perceived as highly valuable to stakeholders. We believe this product has enormous commercial viability and public health importance and that its innovative combination of features will overcome obstacles to adoption that have plagued other electronic pain assessment systems.

描述（由申请人提供）：此II期应用程序继续开发疼痛评估访谈网络 - 临床咨询系统（PAINCAS），这是对慢性疼痛患者的系统和经过测试的计算机管理评估。初步评估和随访模块评估患者进入或继续治疗慢性疼痛时的相关健康和功能信息。提供者的初始和后续报告以方便的方式组织了患者信息，从而引起了提供者注意的健康和功能性问题。评估包括评估滥用和滥用处方止痛药的风险。 Paincas还会生成专门用于患者的报告。最后，止痛药包括以提供商为中心的工具，用于上传和分析接受过止痛药评估的患者的总数据，以及可以帮助指导治疗的决策支持资源。这样的疼痛管理资源将使医生在诊所遭遇中最大限度地提高可用时间，同时最大程度地减少治疗的潜在不利影响，例如滥用或滥用镇痛药。因素的融合表明，时间是诸如PAINCAS之类的临床工具的合适时间：（1）增加医疗保健政策制定者和付款人的压力，以系统化护理，文件，风险评估和处方；（2）公众对适当疼痛治疗的要求；（3）公共，工业和监管者对处方药滥用和滥用的关注；（4）在临床环境中增加对计算机评估和工具（包括EMR）的接受；（5）增加对临床途径和疾病管理的兴趣，以提高护理效率和质量，以及（6）从多维角度了解某些慢性病的重要性。尽管需要和以前的几项努力进行电子疼痛评估，但美国疼痛医学学院（AAPM）指出，尚未广泛采用任何系统。在我们先前开发和传播电子评估的工作以及为系统增加价值的功能的创新组合的基础上，可以提出强烈的案例，即采用止痛药。在第一阶段，为系统设计奠定了基础，该系统将适合临床活动的流动，满足重要的评估和报告需求，并直接向患者提供相关信息。第二阶段将看到评估和设计的剩余组成部分以及将在现场试验中测试的完成的止痛药系统的建设。在第二阶段，疼痛专业诊所中患者的多级，受控的，随机的临床试验将测试止痛药对仅疼痛评估的治疗过程和结果的影响，仅处理治疗状况和常态治疗。经过测试的假设是，止痛药将：1）标准化慢性疼痛评估的文档，2）增加对医疗访问期间适当主题和问题的讨论的可能性，以及3）提高患者对治疗的满意度。次要分析将检查止痛药的使用与改善疼痛功能，情绪和滥用/滥用药物的程度。拟议的止痛药有潜在地解决了现有的努力，以增强慢性疼痛的评估和实践。公共卫生相关性：随着社会越来越多地要求医疗专业人员解决慢性疼痛患者的复杂临床表现，越来越重要的是，提供者对标准化计算机管理的评估以及计算机化治疗建议的好处越来越重要。成功开发和传播全面的，综合的疼痛评估访谈网络 - 临床咨询系统（PAINCAS）将在增强慢性疼痛评估和治疗方面距离一定距离，并被认为对利益相关者高度有价值。我们认为，该产品具有巨大的商业生存能力和公共健康重要性，其创新功能组合将克服困扰其他电子疼痛评估系统的采用障碍。