Pain Assessment Interview and Clinical Advisory System

疼痛评估访谈和临床咨询系统

• 批准号: 7481406
• 负责人: Stephen F Butler
• 金额: $ 14.24万
• 依托单位: INFLEXXION, INC.
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2010-01-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7481406
• 关键词: Address; Alcohol or Other Drugs use; Algorithms; Analgesics; Classification; Clinic; Clinical; Collaborations; Complex; Computers; Condition; Country; Data; Data Aggregation; Development; Environment; Feedback; Flowcharts; Goals; Health Insurance Portability and Accountability Act; Health Status; Healthcare; Intake; Intervention; Interview; Medical; Monitor; Numbers; Output; Pain; Pain Measurement; Pain management; Patients; Persons; Pharmaceutical Preparations; Phase; Physicians; Primary Care Physician; Provider; Public Health; Recommendation; Reporting; Research; Resources; Sampling; Screening procedure; Series; Social Aspects of Cancer; Societies; Specialist; Substance abuse problem; Symptoms; Syndrome; System; Technology; Testing; Time; Training; Visit; addiction; base; chronic pain; computerized; concept; design; follow-up; illiterate; neglect; programs; response; satisfaction; tool; treatment planning

DESCRIPTION (provided by applicant): This application builds on programmatic research at Inflexxion to develop the PAIN Clinical Advisory System (PAIN-CAS), a systematic and validated assessment of pain patients along with provider reports containing treatment recommendations and patient feedback reports. Such a pain management resource, with up-to-date specific information about patients' health status, would allow a physician to maximize the available time in an encounter while minimizing potential adverse impacts of treatment, such as addiction to analgesics. Chronic pain is a costly syndrome that influences every aspect of a person's functioning. Treatment of chronic pain, by definition, regularly addresses complicated clinical presentations, including comorbid medical conditions, psychiatric problems, and perhaps uniquely, substance abuse potential. Despite this complexity, treatment decisions are based on ever-briefer clinic encounters that are increasingly conducted by non-specialists. This tends to result in an over-focus on medical interventions and insufficient emphasis on (seemingly) unrelated psychosocial issues that may exacerbate pain. Patients and providers alike are frustrated by pain symptoms requiring repeated visits that yield limited improvement. The proposed PAIN-CAS utilizes Inflexxion's expertise in applying technology to address healthcare problems in an effort to impact how pain management is conducted. Key features of PAIN-CAS include: (1) Patient Assessment Module/Intake and Follow-up Assessments, which will assess pain, substance use, psychiatric status, and comorbid physical conditions, along with screening for addiction potential and monitoring of medication misuse and abuse. The assessment component will be designed to be easily completed by the large number of illiterate patients in the US. (2) Provider Reports will include an Intake Report, complete with treatment recommendations, and a Follow-up Visit Report. (3) A patient feedback report, tailored to patients' responses to the assessments, will be designed to enhance patient empowerment and to encourage active participation and cooperation with treatment. Finally, (4) an Online Tool Kit will allow providers to upload confidential, HIPAA compliant data from their clinic and examine their own aggregate data and compare these data with uniform aggregate data collected at other participating clinics around the country. In collaboration with an Expert Advisory Panel, Inflexxion will achieve an ambitious series of goals in Phase I, including (1) creation of sample report formats for provider and patient output of the PAIN-CAS, (2) creation of pain treatment algorithms to be programmed into the system, (3) outline of the functionality of the Online Tool Kit, (4) creation of a flowchart and outline of PAIN-CAS assessments, (5) creation and testing of a demonstration program, (6) creation of a Technical Brief for the PAIN-CAS program, and (7) completion of satisfaction and acceptance studies of the PAIN-CAS components with providers and pain patients. The proposed PAIN-CAS potentially addresses limitations of existing efforts to enhance assessment and practice in the treatment of chronic pain. Project Narrative: 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 Clinical Advisory System (PAIN-CAS) will go some distance toward enhancing assessment and treatment of chronic pain and be perceived as highly valuable to stakeholders. Thus, we believe this product has enormous commercial viability and public health importance.

描述（由申请人提供）：本申请建立在inflexion的程序性研究基础上，旨在开发疼痛临床咨询系统（PAIN- cas），这是一种对疼痛患者进行系统和有效评估的系统，以及包含治疗建议和患者反馈报告的提供者报告。这种疼痛管理资源，具有关于患者健康状况的最新具体信息，将使医生能够最大限度地利用就诊时间，同时最大限度地减少治疗的潜在不利影响，例如对止痛药成瘾。慢性疼痛是一种代价高昂的综合症，它会影响一个人的各个方面。根据定义，慢性疼痛的治疗通常涉及复杂的临床表现，包括合并症、精神问题，以及可能独特的药物滥用潜力。尽管这种复杂性，治疗决定是基于越来越短的门诊接触，越来越多的非专业人员进行。这往往导致过度关注医疗干预，而对可能加剧疼痛的（看似）不相关的社会心理问题重视不足。病人和医生都对疼痛症状感到沮丧，需要反复就诊，但改善有限。拟议的pain - cas利用inflexion在应用技术解决医疗保健问题方面的专业知识，努力影响疼痛管理的实施方式。pain - cas的主要特点包括：(1)患者评估模块/摄入和随访评估，它将评估疼痛、物质使用、精神状态和共病身体状况，同时筛查成瘾潜力和监测药物滥用和滥用。评估部分将被设计为美国大量文盲患者很容易完成。(2)提供者报告应包括一份包含治疗建议的入院报告和一份随访报告。(3)针对患者对评估的反应，将设计一份患者反馈报告，以增强患者的权能，鼓励患者积极参与和配合治疗。最后，(4)一个在线工具包将允许提供者从他们的诊所上传机密的、符合HIPAA的数据，并检查他们自己的汇总数据，并将这些数据与全国其他参与诊所收集的统一汇总数据进行比较。通过与专家咨询小组的合作，inflexion将在第一阶段实现一系列雄心勃勃的目标，包括(1)为提供者和患者输出pain - cas创建样本报告格式，(2)创建将被编程到系统中的疼痛治疗算法，(3)概述在线工具包的功能，(4)创建流程图和概述pain - cas评估，(5)创建和测试演示程序。(6)创建pain - cas项目的技术概要，(7)与提供者和疼痛患者一起完成pain - cas组件的满意度和接受度研究。提出的pain - cas潜在地解决了现有努力的局限性，以加强慢性疼痛治疗的评估和实践。项目描述：随着社会对医疗专业人员处理慢性疼痛患者复杂临床表现的要求越来越高，提供者从标准化的计算机管理评估和计算机治疗建议中获益变得越来越重要。成功开发和传播一个全面的、综合的疼痛临床咨询系统（PAIN- cas）将在一定程度上加强慢性疼痛的评估和治疗，并被认为对利益相关者具有很高的价值。因此，我们相信该产品具有巨大的商业可行性和公共卫生重要性。