Pain Assessment Interview and Clinical Advisory System

疼痛评估访谈和临床咨询系统

• 批准号: 8231327
• 负责人: Stephen F Butler
• 金额: $ 63.83万
• 依托单位: INFLEXXION, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8231327
• 关键词: Academy; Address; Adopted; Adoption; Agreement; Alcohol or Other Drugs use; American; Analgesics; Attention; Caring; Chronic; Client satisfaction; Clinic; Clinical; Clinical Management; Clinical Pathways; Cognitive; Complex; Computers; Conduct Clinical Trials; Data; Data Aggregation; Data Analyses; Development; Development Plans; Disease Management; Documentation; Electronics; Environment; Evaluation; Flowcharts; Health; Health Policy; Healthcare; Individual; Industry; Intake; Interview; Medical; Medicine; Modeling; Monitor; Moods; Opioid; Outcome; Pain; Pain Measurement; Pain management; Paper; Patient Monitoring; Patient Self-Report; Patients; Pattern; Persons; Pharmaceutical Preparations; Phase; Physicians; Plague; Policy Maker; Practice Guidelines; Process; Production; Provider; Public Health; Quality of Care; Quality of life; Questionnaires; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recommendation; Reporting; Research; Resources; Risk; Risk Assessment; Risk Management; Sampling; Societies; Specialist; Standardization; Substance abuse problem; Symptoms; Syndrome; System; Technology; Testing; Time; Visit; Work; chronic pain; clinical care; clinical practice; computerized; design; follow-up; illiteracy; improved; innovation; interest; medical specialties; meetings; prescription opioid; pressure; primary outcome; programs; prototype; psychosocial; public health relevance; response; success; tool; treatment as usual; usability

DESCRIPTION (provided by applicant): This Phase II application continues development of the Pain Assessment Interview Network - Clinical Advisory System (painCAS), a systematic and tested computer-administered assessment of chronic pain patients. Initial Assessment and Follow-up modules assess relevant health and functioning information of patients as they enter or continue treatment for chronic pain. Provider Initial and Follow-up Reports organize patient information in a convenient way that brings to the provider's attention notable health and functioning issues. The assessment includes an evaluation of risk for misuse and abuse of prescription pain medication. painCAS also generates a report specifically intended for patients. Finally, painCAS includes provider-focused tools for uploading and analyzing aggregate data for patients who have taken the painCAS assessments, as well as a Decision Support resource that can help guide treatment. Such a pain management resource would allow a physician to maximize the available time in a clinic encounter while minimizing potential adverse impacts of treatment, such as abuse or misuse of analgesics. A convergence of factors suggests the time is right for a clinical tool like the painCAS: (1) increasing pressure from healthcare policy makers and payors to systematize care, documentation, risk assessment, and prescribing; (2) public demands for adequate pain treatments; (3) public, industry, and regulator concerns about prescription medication misuse and abuse; (4) increasing acceptance of computer assessment and tools (including EMRs) in clinical settings; (5) increasing interest in clinical pathways and disease management to improve the efficiency and quality of care, and (6) an increasing recognition of the importance of understanding certain chronic conditions from a multidimensional perspective. Despite the need and several prior efforts to develop electronic pain assessments, the American Academy of Pain Medicine (AAPM) notes that no system has yet been widely adopted. Building on our prior work developing and disseminating electronic assessments as well as an innovative combination of features that add value to the system, a strong case can be made that the painCAS will be adopted. During Phase I, the groundwork was laid for a system design that will fit into the flow of clinical activities, meet important assessment and reporting needs, and provide relevant information directly to patients. Phase II will see the completion of remaining components of the assessments and design and the building of the completed painCAS system to be tested in a field trial. In Phase II, a multilevel, controlled, randomized clinical trial of patients in pain specialty clinics will test the impact of painCAS on treatment process and outcome against a painCAS assessment only condition and a treatment-as-usual condition. The tested hypotheses are that the painCAS will: 1) standardize documentation of chronic pain assessments, 2) increase the likelihood of discussion of appropriate topics and issues during the medical visit, and 3) improve the patient's satisfaction with treatment. Secondary analyses will examine the extent to which painCAS use is associated with improvement in pain functioning, mood, and misuse/abuse of medications. The proposed painCAS potentially addresses limitations of existing efforts to enhance assessment and practice in the treatment of chronic pain. PUBLIC HEALTH RELEVANCE: 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 Assessment Interview Network - Clinical Advisory System (painCAS) will go some distance toward enhancing assessment and treatment of chronic pain and be perceived as highly valuable to stakeholders. We believe this product has enormous commercial viability and public health importance and that its innovative combination of features will overcome obstacles to adoption that have plagued other electronic pain assessment systems.

描述（由申请人提供）：该第二阶段申请继续开发疼痛评估访谈网络 - 临床咨询系统 (painCAS)，这是一种对慢性疼痛患者进行系统且经过测试的计算机管理评估。初始评估和随访模块评估患者进入或继续治疗慢性疼痛时的相关健康和功能信息。提供者初始报告和后续报告以方便的方式组织患者信息，引起提供者注意显着的健康和功能问题。该评估包括对误用和滥用处方止痛药的风险进行评估。 painCAS 还生成专门针对患者的报告。最后，painCAS 包括以提供者为中心的工具，用于上传和分析接受 painCAS 评估的患者的汇总数据，以及可以帮助指导治疗的决策支持资源。这种疼痛管理资源将使医生能够最大限度地利用诊所的可用时间，同时最大限度地减少治疗的潜在不利影响，例如滥用或误用镇痛药。综合因素表明，现在是时候使用 painCAS 等临床工具了：(1) 医疗政策制定者和付款人要求将护理、记录、风险评估和处方系统化的压力越来越大； (2) 公众对充分疼痛治疗的要求； (3) 公众、行业和监管机构对处方药误用和滥用的担忧； (4) 提高临床环境中计算机评估和工具（包括电子病历）的接受度； (5) 对临床路径和疾病管理的兴趣日益浓厚，以提高护理效率和质量；(6) 人们越来越认识到从多维角度理解某些慢性病的重要性。尽管需要开发电子疼痛评估并且之前已经做出了一些努力，但美国疼痛医学会 (AAPM) 指出，目前还没有任何系统被广泛采用。基于我们之前开发和传播电子评估的工作以及为系统增加价值的创新功能组合，可以充分证明 painCAS 将被采用。在第一阶段，为系统设计奠定了基础，该系统设计将适应临床活动流程，满足重要的评估和报告需求，并直接向患者提供相关信息。第二阶段将完成评估和设计的其余部分，并构建完整的 painCAS 系统，以便在现场试验中进行测试。在第二阶段，对疼痛专科诊所患者进行的多层次、对照、随机临床试验将测试 painCAS 对治疗过程和结果的影响，对比仅 painCAS 评估条件和常规治疗条件。经测试的假设是 painCAS 将：1）标准化慢性疼痛评估的记录，2）增加就诊期间讨论适当主题和问题的可能性，以及 3）提高患者对治疗的满意度。二次分析将检查 painCAS 的使用与疼痛功能、情绪和药物滥用/滥用改善的相关程度。拟议的 painCAS 可能会解决现有努力的局限性，以加强慢性疼痛治疗的评估和实践。 公共卫生相关性：随着社会越来越要求医疗专业人员解决慢性疼痛患者的复杂临床表现，提供者受益于标准化计算机管理评估以及计算机化治疗建议变得越来越重要。成功开发和传播全面、综合的疼痛评估访谈网络 - 临床咨询系统 (painCAS) 将大大有助于加强慢性疼痛的评估和治疗，并被利益相关者视为非常有价值。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，其创新的功能组合将克服困扰其他电子疼痛评估系统的采用障碍。

项目成果

Impact of an Electronic Pain and Opioid Risk Assessment Program: Are There Improvements in Patient Encounters and Clinic Notes?

• DOI: 10.1093/pm/pnw033
• 发表时间: 2016-11-01
• 期刊: PAIN MEDICINE
• 影响因子: 3.1
• 作者: Butler, Stephen F.;Zacharoff, Kevin L.;Jamison, Robert N.
• 通讯作者: Jamison, Robert N.

Psychometric evaluation of the PainCAS Interference with Daily Activities, Psychological/Emotional Distress, and Pain scales.

PainCAS 对日常活动、心理/情绪困扰和疼痛量表干扰的心理测量评估。

• DOI: 10.1007/s11136-017-1766-3
• 发表时间: 2018
• 期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
• 作者: McCaffrey,StaceyA;Black,RyanA;Butler,StephenF;Inflexxion,Inc.
• 通讯作者: Inflexxion,Inc.