Understanding Pain after Dental Procedures

项目摘要/摘要 看牙医后，疼痛是一种常见的、不受欢迎的后果。事实上，疼痛被认为是第五种 生命体征，许多人将其描述为不良事件(AE)。在影响后最常用的局部 麻醉剂减少，牙科患者必须依靠自己和自己对疼痛的理解 牙科手术后的管理。这导致了对处方阿片类药物的过度依赖，因为 没有办法在患者离开诊所后主动跟踪他们的疼痛。了解有效/适当的疼痛 对于牙科管理，我们需要检查患者经历的疼痛程度是由哪些牙科手术引起的。 这样的清单将允许提供者预测并更好地管理他们患者的术后疼痛。 创新的移动应用程序和互联的医疗技术，允许实时跟踪 患者的症状、功能状态和生活质量，为医疗专业人员提供的数据 以前不可用，并促进了患者的参与、共同决策和遵守 治疗计划。我们建议通过以下方式探索牙科疼痛监测和管理的创新解决方案 实施移动电话技术，在术后危急阶段监测患者的疼痛情况。 我们认为，通过使用移动电话跟踪患者报告的结果(PRO)，亚 最佳的疼痛体验将很容易被识别。这项研究将证明，专业人员提供了可行的 数据。这项研究也可以作为在牙科实践中实施新的健康信息技术(MHealth)的模式 提高患者参与度。 这项观察性研究将在NDPBRN(基于牙科实践的研究网络)进行 我们认为这些地方是发展这种实际和集中的术后疼痛的理想场所 管理学。我们将招募50家NDPBRN诊所和4050名患者，他们将收到推送通知 在他们的手机上以指定的时间间隔使用FollowApp.Care发送短信 他们的牙科手术。这一实施现有并经过测试的mHealth系统的创新方法 技术(FollowApp.Care)进入NDPBRN真实的牙科办公室环境将主动跟踪疼痛 以及牙科手术后的其他并发症。通过患者使用他们的手机，我们希望 迅速、准确地识别外科牙科手术的具体疼痛程度。 在研究的UG3阶段(Yr1-2)，我们将编写UG3-Aim1中的所有研究材料，并在 UG3-AIM 2为研究的实施制定设计特点和工作流程。在UH3阶段 (YR 3-6)我们将在UH3-Aim1试点测试程序，以简化NDPBRN中的数据收集和工作流程 牙科诊所。在UH3-Aim 2中，我们将根据手术类型评估术后疼痛强度；在UH3-Aim 3中，我们将 将评估提供者和患者的术后管理策略，在UH3-AIM 4中，我们将评估患者的 以及提供商对mHealth技术的接受程度。

Project Summary/Abstract Pain is a common, and unwelcome aftermath of seeing the dentist. Indeed, pain has been deemed the fifth vital sign and many describe it as an adverse event (AE). After the effects of the most commonly-used local anesthetic diminishes, dental patients must rely on themselves and their own understanding for pain management following dental procedures. This has led to an over-reliance on prescribed opioids as there are no means to actively track patients' pain once they leave the clinic. To understand effective/appropriate pain management, we need to examine the pain levels experienced by patients caused by which dental procedures. Such an inventory will allow providers to anticipate and better manage their patients' post-operative pain. Innovative mobile applications and connected health technologies that allow real-time tracking of patients' symptoms, functional status and quality of life, provide healthcare professionals with data that were previously unavailable, and have fostered patient engagement, shared decision-making and adherence to treatment plans. We propose to explore an innovative solution to dental pain monitoring and management by implementing mobile phone technology to monitor patients' pain during the critical acute post-operative phase. We believe that by tracking patient reported outcomes (PROs) using mobile phones, patients with sub- optimal pain experiences will be easily identified. This study will demonstrate that PROs provide actionable data. This study can also serve as a model for implementing new health IT (mHealth) within dental practices to improve patient engagement. This observational study will be conducted at NDPBRN (Dental Practice-based Research Network) sites, which we believe are ideal for the development of this practical and focused post-operative pain management study. We will recruit 50 NDPBRN practices and 4050 patients who will receive push notifications through text messages using FollowApp.Care on their mobile phones at designated time intervals following their dental procedure. This innovative approach of implementing an existing and tested mHealth system technology (FollowApp.Care) into the real-world dental office setting of the NDPBRN will actively track pain and other complications following dental procedures. By patients using their mobile phones, we expect to promptly and precisely identify specific levels of pain for surgical dental procedures. During the UG3 phase of the study (Yr 1-2) we will develop all study materials in UG3-Aim1, and in UG3-Aim 2 develop the design features and workflow for implementation of the study. During the UH3 phase (Yr 3-6) we will in UH3-Aim1, pilot test procedures to streamline data collection and workflow in the NDPBRN dental office. In UH3- Aim 2 we will assess post-operative pain intensity by procedure type; in UH3-Aim 3 we will assess provider and patient post-op management strategies and in UH3-Aim 4, we will evaluate patients' and providers' acceptance of the mHealth technology.