Understanding Pain after Dental Procedures

项目概要/摘要 疼痛是看牙医后常见且不受欢迎的后果。事实上，疼痛已被视为第五位 生命体征，许多人将其描述为不良事件 (AE)。最常用的局部后效果 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 一旦患者离开诊所，就没有办法主动追踪他们的疼痛情况。了解有效/适当的疼痛 管理中，我们需要检查患者因哪种牙科手术而经历的疼痛程度。 这样的库存将使提供者能够预测并更好地管理患者的术后疼痛。 创新的移动应用程序和互联健康技术，可以实时跟踪 患者的症状、功能状态和生活质量，为医疗保健专业人员提供数据 以前无法实现的，并且促进了患者参与、共同决策和遵守 治疗计划。我们建议探索一种创新的牙痛监测和管理解决方案 采用移动电话技术来监测术后关键急性期患者的疼痛。 我们相信，通过使用手机跟踪患者报告结果 (PRO)，患有亚健康的患者可以 最佳的疼痛体验将很容易被识别。这项研究将证明 PRO 提供了可行的 数据。这项研究还可以作为在牙科诊所中实施新的健康 IT (mHealth) 的模型，以 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 我们认为这些网站对于开发这种实用且集中的术后疼痛是理想的 管理研究。我们将招募 50 个 NDPBRN 诊所和 4050 名患者，他们将收到推送通知 在指定的时间间隔内使用手机上的 FollowApp.Care 通过短信发送 他们的牙科手术。这种实施现有且经过测试的移动医疗系统的创新方法 将技术 (FollowApp.Care) 引入 NDPBRN 的真实牙科诊所环境中，将主动跟踪疼痛 以及牙科手术后的其他并发症。通过患者使用手机，我们希望 及时准确地识别牙科手术的具体疼痛程度。 在 UG3 学习阶段（第 1-2 年），我们将开发 UG3-Aim1 中的所有学习材料，并在 UG3-Aim 2 开发用于实施研究的设计功能和工作流程。在UH3阶段 （第 3-6 年）我们将在 UH3-Aim1 中进行试点测试程序，以简化 NDPBRN 中的数据收集和工作流程 牙科诊所。在 UH3-目标 2 中，我们将按手术类型评估术后疼痛强度；在UH3-目标3中我们 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 以及提供商对移动医疗技术的接受程度。

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.