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Observational Study of the Impact of Genetic Testing on Healthcare Decisions and Care in Interventional Pain Management

Conditions
Musculoskeletal Pain
Pain
Chronic Pain
Pain, Intractable
Neck Pain
Nociceptive Pain
Back Pain
Neuropathic Pain
Interventions
Other: Observational
Registration Number
NCT02485795
Lead Sponsor
Proove Bioscience, Inc.
Brief Summary

The purpose of this study is to evaluate the impact of genetic testing on healthcare decisions and patient outcomes in interventional pain management clinical care. Results of genetic testing will also be compared with the clinical outcome measures collected to discover novel genetic factors that may influence patient care.

Detailed Description

Specific genetic variations have been identified that result in alteration of expression or function of receptors, enzymes, and transporters that are relevant to the safety and efficacy of a medical treatment. By providing information regarding the genetic risks and the most effective therapy for an individual patient, clinicians may improve the efficacy of treatment and decrease the risk of adverse events.

The purpose of this study is to evaluate how currently available genetic tests are being implemented in various interventional pain management clinics around the United States, and whether this information results in benefits to patient care. Considering patient genotype correlates with pain sensitivity and perception, as well as autonomic nervous system dysfunction due to variations in sodium and potassium channels, genotypic associations can significantly improve outcomes in interventional pain management modalities including:

* Injections (also called nerve blocks using medications), such as steroids and opioids, including epidural steroid injections, facet joint injections, single nerve root blocks, and sacroiliac joint injections;

* Radiofrequency Rhizotomy (radiofrequency ablation and neuroablation), using x-ray guidance and a needle with an electrode at the tip that gets heated, to temporarily turn off a nerve's ability to send pain messages to the brain; and,

* Intrathecal pump implants which provide potent medications straight to the source of pain.

Patient that are receiving Proove Bioscience's genetic testing will complete validated questionnaires to measure specific outcomes related to their treatment at each clinical visit, including medication efficacy, reduction in adverse drug events, and healthcare utilization. Physicians will document any changes made to treatment regimens, including adjustments to medications or non-pharmacological treatments, and any improvements in the outcome measures. Statistical analysis will be performed to calculate relationships between genotypic and phenotypic data points collected in this study.

The results of this study will provide a measurable understanding of the medical and economic value of implementing genetic testing into interventional pain management. Furthermore, data points collected will be used to examine novel correlations and associations between single nucleotide polymorphisms and longitudinal clinical outcome measures.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
50000
Inclusion Criteria
  • Provide signed and dated informed consent form
  • Willing to comply with all study procedures and be available for the duration of the study
  • Male or Female, at least 18 years of age
  • Currently taking or a candidate for opioid pain medication
  • Documented or recent complaint of pain within 90 days (location to be documented in the case report form) with initial date of onset
Exclusion Criteria
  • Severe hepatic or renal disease (where current pharmaceutical dosing is affected and/or requires adjustment of standard dosing prior to PGx testing)
  • Significant diminished mental capacity that is unable to understand the protocol, surveys and questionnaires; unable to read/write English or Spanish.
  • Recent febrile illness that precludes or delays participation by more than 1 month
  • Pregnancy or lactation
  • Participation in a clinical study that may interfere with participation in this study
  • Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Pain patientsObservationalObservational; Patients presenting to interventional pain management centers for therapy.
Primary Outcome Measures
NameTimeMethod
Medication dosage prescribed to the participants60 days
Pain Scores on the Pain Numeric Rating Scale (NRS)60 days
Number of Participants that Experience of Adverse EventsUp to 2 years
Severity of Adverse Events Experienced by ParticipantsUp to 2 years
Function/Disability assessment on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)60 days
Type of Adverse Events Experienced by ParticipantsUp to 2 years
Type of treatments selected for participants60 days
Self-rated response levels to prescribed medications60 days
Frequency of participant urine drug screens60 days
Secondary Outcome Measures
NameTimeMethod
Assessment of previous treatments60 days
Co-occurring disorders reported by ICD-9/10 code60 days
Urine drug screen results60 days

Trial Locations

Locations (31)

Central Arizona Pain Institute

🇺🇸

Prescott, Arizona, United States

Steven J. Waltrip M.D. Inc.

🇺🇸

Beverly Hills, California, United States

Spine Specialty Clinic of Arkansas

🇺🇸

Heber Springs, Arkansas, United States

Memorial Orthopaedic Surgical Group

🇺🇸

Long Beach, California, United States

Nuvo Spine

🇺🇸

Encino, California, United States

Dr. Anuj Gupta

🇺🇸

Vista, California, United States

Spinal Interventional Research

🇺🇸

Gulf Breeze, Florida, United States

Panama Interventional Pain Management

🇺🇸

Panama City Beach, Florida, United States

Stuart B Krost MD

🇺🇸

Lake Worth, Florida, United States

Compass Pain Care

🇺🇸

Charleston, South Carolina, United States

Wellspring Pain Solutions

🇺🇸

Columbus, Indiana, United States

Dr. Todd Joye

🇺🇸

Mount Pleasant, South Carolina, United States

Coastal Interventional Pain Associates

🇺🇸

Myrtle Beach, South Carolina, United States

Pain, Spine and Sports Medicine

🇺🇸

Myrtle Beach, South Carolina, United States

Palmetto Spine and Pain Care Consultants

🇺🇸

Myrtle Beach, South Carolina, United States

El Paso Orthopaedic Surgery Group

🇺🇸

El Paso, Texas, United States

Medical Centre Pain Mgmt

🇺🇸

Fort Worth, Texas, United States

North Hills Pain

🇺🇸

Hurst, Texas, United States

KSF Orthopaedic Center

🇺🇸

Houston, Texas, United States

The Woodlands Pain Institute

🇺🇸

Shenandoah, Texas, United States

Victoria Pain and Rehabilitation Center

🇺🇸

Victoria, Texas, United States

National Spine And Pain Centers

🇺🇸

McLean, Virginia, United States

Northwest Spine and Pain Medicine

🇺🇸

Spokane, Washington, United States

Cedars Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Snibbe Orthopedics

🇺🇸

Los Angeles, California, United States

Integrated Pain Solutions of South FL

🇺🇸

Fort Lauderdale, Florida, United States

Interventional Pain Physicians of South Florida

🇺🇸

Pembroke Pines, Florida, United States

Neurological Spine & Pain

🇺🇸

Savannah, Georgia, United States

Palmetto Pain Management

🇺🇸

Columbia, South Carolina, United States

TX Spine and Joint

🇺🇸

Houston, Texas, United States

San Diego Pain Institute

🇺🇸

San Diego, California, United States

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