COMPUTERIZED PAIN REPORT & NURSING PAIN CONSULT PROTOCO

对于每年超过80万的美国人来说，无法缓解的癌症疼痛是一种痛苦。 主要健康问题部分归因于评估困难， 缺乏使用已知有效的止痛药的知识 for 85% to 95% of cancer癌症patients患者with pain疼痛. 作为 为了解决不必要的痛苦，我们提出了一个随机的临床 一项比较UW癌症中心常规护理效果的试验， 计算机化疼痛评估和提供者决策支持协议 a）患者结局（疼痛强度、质量、缓解;满意度 与疼痛水平）在176例疼痛相关的患者的不同样本中， 骨转移; B）提供者结果（疼痛记录; 处方镇痛药的适当性;门诊访视时间）， 肿瘤学专家样本;以及c）患者-提供者伙伴关系 结果（录音诊所期间以患者为中心的讨论内容 访问）。 在前测试和后测试设计中，患者将完成 通常的疼痛评估和使用新的计算机疼痛评估工具 记录他们的痛苦 分配至新研究组的患者的疼痛数据 协议将与他们的肿瘤学家沿着与计算机共享 生成的咨询，包括适当的镇痛药列表 病人疼痛的特征 之间的相互作用 在常规门诊访视期间，将对患者和提供者进行录音 并分析了访问期间的通信类型。 一周 之后，患者将完成计算机化疼痛评估工具， 记录任何针对其疼痛的治疗方法的效果。 此外，我们还将描述患者和提供者对 使用半结构化问题的计算机化疼痛工具及其应用 对数据进行内容分析。研究结果将用于指导 修订工具，并计划组织一级的实施 作为电子医疗系统的接口 记录

For more than 800,000 Americans each year, unrelieved cancer pain is a major health problem attributed in part to assessment difficulties and to lack of knowledge about using the analgesics known to be effective for 85 percent to 95 percent of cancer patients with pain. As a solution to the unnecessary suffering, we propose a randomized clinical trial to compare effects of usual-care in the UW Cancer Center or a protocol of computerized pain assessment and provider decision support on: a) patient outcomes (pain intensity, quality, relief; satisfaction with pain level) in a diverse sample of 176 patients with pain related to bone metastasis; b) provider outcomes (pain documentation; appropriateness of prescribed analgesics; clinic visit length) in a sample of oncology specialists; and c) patient-provider partnership outcomes (patient-centered discussion content during audiotaped clinic visits). In a pre-test and post-test design, patients will complete usual pain assessments and use a new computerized pain assessment tool to document their pain. Pain data from patients assigned to the new protocol will be shared with their oncologists along with a computer generated consultation that includes a list of analgesics appropriate for the character of the patient's pain. The interaction between the patient and the provider during routine clinic visits will be audiotaped and analyzed for types of communication during the visit. One week later, patients will complete the computerized pain assessment tool to document the effect of any therapies prescribed for their pain. Additionally we will describe patient and provider receptivity to the computerized pain tool using semi-structured questions and applying content analysis to the data. Study findings will be used to guide revisions of the tool and to plan organizational level implementation of this new technology as an interface with the electronic health care record.