System for Tracking and Managing Pain (STAMP)

疼痛跟踪和管理系统 (STAMP)

• 批准号: 8314734
• 负责人: Camilla C Knott
• 金额: $ 15.54万
• 依托单位: APTIMA, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2013-08-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8314734
• 关键词: Accounting; Activities of Daily Living; Adherence; Affect; Age; Aging; American; Assisted Living Facilities; Behavioral; Caring; Chronic; Collaborations; Complex; Confusion; Costs and Benefits; Data; Decision Making; Degenerative polyarthritis; Development; Development Plans; Devices; Diabetes Mellitus; Diagnosis; Disease; Education; Elderly; Evaluation; Frequencies; Goals; Health; Health Personnel; Health Services Accessibility; Hip Pain; Home Nursing Care; Home environment; Hospitalization; Hypertension; Imagery; Impaired cognition; Intervention; Knee Osteoarthritis; Lead; Life; Link; Literature; Marketing; Measures; Mediating; Mediator of activation protein; Medical; Mental Depression; Monitor; Moods; Obesity; Outcome; Pain; Pain Measurement; Pain management; Patient Education; Patients; Personality; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Prevalence; Provider; Quality of life; Regimen; Risk; Self Management; Sleep; Sleeplessness; Social isolation; Societies; Solutions; Sterile coverings; Sum; Symptoms; System; Techniques; Technology; Unnecessary Surgery; age related; aging population; chronic pain; coping; cost; design; diaries; disability; experience; functional decline; high risk; improved; improved functioning; information display; innovation; patient oriented; prototype; research and development; response; statistics; system architecture; systems research; tool; treatment planning; treatment program

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.

描述（由申请人提供）：骨关节炎（OA）是导致美国老年人残疾的最常见疾病之一[13]。到2030年，大约20%的人口（7200万人）将超过65岁，并处于OA的高风险中。伴随OA的疼痛和残疾通常会导致老年人抑郁、社交孤立和失眠的风险增加，以及功能衰退增加。成功的疼痛管理对于改善老年OA患者的生活质量至关重要。 以患者为中心的方法治疗慢性疾病，如OA [6，7，2，15，34，35，5]与更好的健康结果[2，15，34，7]相关，包括降低老年人的疼痛频率[6]。这种方法的关键是：（1）患者自我管理，特别是通过教育（即，自我教育）[2，34]，以及（2）通过患者-医疗保健提供者（HCP）合作，共同制定治疗目标和选项[2，35，39]。尽管以患者为中心的方法有效，但没有商业上可用的疼痛管理工具支持它。现有的疼痛管理工具专注于记录，而不是通过典型和有限的因素集（例如，药物或活动），并排除其他已知的疼痛介质（例如，[32]睡眠，情绪，影响[30]）。此外，我们评估的那些人忽略了衰老中已知的认知障碍[10，11]，例如，记得了 鉴于OA疼痛的患病率，对生活质量的负面影响，以及缺乏支持教育和共享医疗决策的老年人友好的疼痛管理工具，我们建议开发和评估疼痛跟踪和管理系统（STAMP）。STAMP将是一种以患者为中心的疼痛体验教育和管理工具，适用于患有OA膝关节和/或髋关节疼痛的老年人。它将捕捉、整合和显示有关疼痛和介导因素的信息， （2）共同的医疗决策。STAMP的创新是将一套全面的疼痛介质测量方法整合到有目的的数据可视化中，直观地呈现全面和相关的信息，便于患者和HCP解释。因此，STAMP将促进患者将坚持的疼痛管理方案的开发，可能减少疼痛，从而减少OA疼痛的住院或疗养院护理。实现我们目标的具体目标是：1）开发STAMP原型可视化和系统架构; 2）评估STAMP在实现教育和共享医疗决策方面的可行性。STAMP的长期目标包括将其扩展到其他慢性疾病，例如，糖尿病和肥胖症，这占了大量本来可以预防的医疗费用。 公共卫生相关性：骨关节炎（OA）困扰着超过2700万美国人，并且是美国老年人中最普遍的残疾之一，仅次于高血压（联邦机构间老龄化相关统计论坛，2010）。提高效率的根本是避免昂贵的技术和治疗方法，而使用低成本的技术和治疗方法可能是有效的。STAMP旨在通过患者及其医疗保健提供者的教育和共享医疗决策来支持自我管理，以更好地管理慢性OA疼痛，从而减少对不必要的手术，住院和护理的需求。

项目成果

How Do Older Adults Manage Osteoarthritis Pain? The Need for a Person-Centered Disease Model.

老年人如何缓解骨关节炎疼痛？

• DOI: 10.1177/1541931213571162
• 发表时间: 2013
• 期刊: Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting. Human Factors and Ergonomics Society. Annual meeting
• 作者: Barg-Walkow,LauraH;McBride,SaraE;Morgan,MichaelJ;Mitzner,TracyL;Knott,CamillaC;Rogers,WendyA
• 通讯作者: Rogers,WendyA