System for Tracking and Managing Pain (STAMP)

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DESCRIPTION (provided by applicant): Osteoarthritis (OA) is one of the most prevalent diseases that lead to disabilities in older Americans [13]. By 2030, approximately 20 percent of the population (72M people) will be over 65 and at high risk for OA. Pain and disability that accompany OA often lead to increased risk of depression, social isolation, and sleeplessness, and increased functional decline in older adults. Successful pain management is critical for improving quality of life in older adults living with OA. Patient-centered approach in treating chronic conditions such as OA [6, 7, 2, 15, 34, 35, 5] haves been linked to better health outcomes [2, 15, 34, 7] including reduced pain frequency in older adults [6]. Vital to this approach is enabling: (1) patient self-management, particularly through education (i.e., self-education) on their condition [2, 34], and (2) Shared Medical Decision-making on treatment goals and options [2, 35, 39] through patient-healthcare provider (HCP) collaboration. Despite efficacy of patient-centered approaches, no commercially-available pain management tools support it. Extant pain management tools focus on documenting and not understanding one's pain experience via typical and limited sets of factors (e.g., medications or activity), and exclud other known pain mediators (e.g., sleep [32], mood, affect [30]). Also, those we evaluated ignored known cognitive impairments in aging [10, 11], e.g., recall. Given OA pain's prevalence, negative impact on quality of life, and the lack of older-adult- friendly pain management tools that support education and shared medical decision-making, we propose to develop and evaluate System for Tracking and Managing Pain (STAMP). STAMP will be a patient-centered pain experience education and management tool for older adults with OA knee and/or hip pain. It will capture, integrate, and display information on pain and mediating factors to enable 1) self education, and 2) shared medical decision-making. STAMP's innovation is the integration of a comprehensive set of measures of pain mediators into purposeful data visualizations that intuitively present comprehensive and relevant information for easy interpretation by patients and HCPs. Thereby, STAMP will facilitate development of pain management regimens that patients will adhere to, potentially decreasing pain and hence hospitalization or nursing home care from OA pain. Specific aims to accomplish our goals are: 1) develop the STAMP prototype visualizations and system architecture; 2) evaluate the feasibility of STAMP in enabling education and shared medical decision-making. Long term goals for STAMP include its extension to other chronic conditions, e.g., diabetes and obesity, which account for a large amount of otherwise preventable medical costs. PUBLIC HEALTH RELEVANCE: Osteoarthritis (OA) afflicts more than 27 million Americans and is one of the most prevalent disabilities among older Americans, second only to hypertension (Federal Interagency Forum on Aging-Related Statistics, 2010). Fundamental to improving efficiency is avoiding expensive technologies and treatments when using lower-cost techniques and treatments can be effective. STAMP will be designed to support self-management through education and shared medical decision making by patients and their healthcare providers to better manage chronic OA pain thereby decreasing the demand for unnecessary surgery, hospitalization, and nursing home care.