Evidence-Based Multidimensional Pain Self-Management Planning: Personalized by and for Veterans via Web-Based Application

基于证据的多维疼痛自我管理规划：通过基于网络的应用程序由退伍军人个性化并为退伍军人提供个性化服务

• 批准号: 10461704
• 负责人: BETH B HOGANS
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10461704
• 关键词: Address; Affect; Area; Back Pain; Caring; Chronic low back pain; Clinical; Counseling; Custom; Data; Decision Making; Development; Discipline of Nursing; Environmental Risk Factor; Evidence based practice; Feedback; Funding; Future; Goals; Hand; Health; Health Personnel; Health system; Improve Access; Injections; Intervention; Knowledge; Lead; Low Back Pain; Measures; Mediation; Medical; Medical Care Team; Medication Management; Mind-Body Intervention; Modeling; Movement; Nonpharmacologic Therapy; Nurses; Online Systems; Operative Surgical Procedures; Outcome; Pain; Pain interference; Pain management; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Pharmacists; Pharmacy facility; Physical activity; Physical therapy; Physicians; Preparation; Primary Health Care; Productivity; Provider; Psyche structure; Psychologist; Psychology; Quality of life; Rehabilitation Outcome; Research; Resistance; Resources; Safety; Seeds; Self Management; Services; Sleep; Specialist; Surveys; Technology; Theft; Time; Training; Veterans; Veterans Health Administration; Vision; Visit; Woman; Women' s Health; Work; base; behavior change; body-mind; care providers; chronic pain; chronic pain management; cost; design; disability; effective therapy; empowered; evidence base; exercise physiologist; experience; fight against; functional outcomes; graphical user interface; improved; innovation; interest; medical specialties; medication safety; mobile application; novel; nutrition; pain outcome; pain reduction; pain self-management; physical therapist; pilot test; preference; programs; prototype; psychoeducation; recruit; rehabilitation research; research and development; sleep health; tool; usability; user centered design

Chronic low back pain is highly prevalent in Veterans, and is often resistant to pharmacological management so that non-pharmacological management is required. For many patients, the most effective approach is comprehensive pain management incorporating multiple therapies addressing: physical, mental, mind-body, sleep, safety, and environmental needs. The ultimate outcome is the development of a coordinated multidimensional evidence-based plan for pain self-management (C-MEPPS) tailored to each patient. This approach, while effective, is highly resource intensive and severely constrained by cost and health system factors. Our goal is a mobile web-based application (App) that provides immediate feedback to Veterans seeking to develop their own pain self-management plan. This will represent a novel, scalable, Veteran-driven solution to chronic low back pain aligned with VA strategic objectives ‘online navigator tools…empowers Veterans to make decisions.’ We are focused on transferring knowledge about evidence-base practices into the primary care context to help Veterans and their healthcare providers manage pain effectively- before it gets worse. We have already developed the App prototype utilizing User-Centered Design principles to optimize the user experience. Our first aim is to develop and pilot test a web-based App for Veterans, including older Veterans and women Veterans, designed to empower each in pain self-management planning: providing access and data-driven guidance about evidence-based multidimensional behavior change. Our second aim is to gather pilot data targeting patient-centered and rehabilitative outcomes such as: increased activity, more sleep time, decreased pain interference and better quality of life; through use of the App and engagement in pain self- management planning. This project brings together the expertise of skilled exercise physiologists, experienced pain and sleep clinical psychologists, pain specialists, clinical educators, geriatricians, women’s health providers, and technology design experts to create a powerful new pipeline for knowledge transfer to patients and providers. Grounded in whole health and integrative approaches, nursing principles, pharmacy practices, physical therapy, and nutrition are also included in the App. We are working as an interprofessional pain-focused team to put the best-available information about non-pharmacological treatments for pain into the hands of Veterans and their primary care providers. Our vision is to improve the lives of Veterans with chronic low back pain, improving access to knowledge and resources and giving Veterans the power to plan their own path to better, more fulfilling living despite chronic low back pain.

慢性腰痛在退伍军人中非常普遍，并且通常对药物有抵抗力 管理，因此需要非药物管理。对于许多患者来说， 最有效的方法是综合疼痛管理，包括多种疗法 解决：身体、心理、身心、睡眠、安全和环境需求。最终 结果是制定了一个协调的多维度循证疼痛计划 自我管理（C-MEPPS），为每位患者量身定制。这种方法虽然有效，但 资源密集型，并受到成本和卫生系统因素的严重制约。 我们的目标是一个移动的基于Web的应用程序（App），为退伍军人提供即时反馈 寻求制定自己的疼痛自我管理计划。这将是一个新颖的，可扩展的， 退伍军人驱动的慢性腰痛解决方案与VA在线战略目标保持一致 导航工具......使退伍军人能够做出决定。我们专注于转移 关于循证实践的知识进入初级保健环境，以帮助退伍军人和 他们的医疗保健提供者有效地管理疼痛-在它变得更糟之前。我们已经 利用以用户为中心的设计原则开发应用程序原型，以优化用户 体验.我们的首要目标是为退伍军人开发和试点测试一个基于网络的应用程序，包括 老年退伍军人和女性退伍军人，旨在赋予每个人在疼痛自我管理 规划：提供关于循证多层面 行为改变我们的第二个目标是收集以患者为中心的试点数据， 康复结果，如：增加活动，更多的睡眠时间，减少疼痛 干预和更好的生活质量;通过使用App和参与疼痛自我治疗， 管理规划 该项目汇集了熟练的运动生理学家的专业知识，经验丰富的疼痛， 睡眠临床心理学家，疼痛专家，临床教育家，老年病学家，妇女健康 供应商和技术设计专家，以创建一个强大的新的知识管道 转移给患者和供应商。立足于整体健康和综合方法， 护理原则，药学实践，物理治疗和营养也包括在 附录我们正在作为一个跨专业的疼痛为重点的团队， 关于非药物治疗疼痛的信息到退伍军人手中， 初级保健提供者。我们的愿景是改善患有慢性腰痛的退伍军人的生活， 改善获得知识和资源的机会，并赋予退伍军人规划自己的能力。 路径更好，更充实的生活，尽管慢性腰痛。