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Computerized Decision Support Tool for Pain Management in Primary Care

Not Applicable
Completed
Conditions
Chronic Pain
Interventions
Other: Early intervention
Other: Delayed intervention
Registration Number
NCT04716621
Lead Sponsor
MJHS Institute for Innovation in Palliative Care
Brief Summary

Chronic pain is highly prevalent, compromises quality of life, and increases care utilization. Primary care providers are challenged to provide effective treatments, use opioid therapy appropriately, and address the adverse consequences of pain. Technology-enabled decision support tools may provide a means to improve pain management in primary care.

The objective of this study was to evaluate a novel electronic health record (EHR)-based decision support tool-plus-education intervention for pain management in primary care.

Detailed Description

This randomized, wait-list controlled trial evaluated a novel EHR-based system for pain management among patients with chronic pain in six practices of a Federally Qualified Health Center network in New York.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
528
Inclusion Criteria
  1. Treated at the Institute for Family Health
  2. Spoke English or Spanish
  3. Received one or more prescriptions for an opioid or nonopioid analgesic during the past three months
  4. Pain screening at the prior three office visits documented scores >3 on the 0-6 scale (FACES, Hicks et al., 2001).
  5. Willingness to complete questionnaires three times
  6. A commitment to return to the practice
  7. Reachable by phone
  8. No evidence of psychopathology or cognitive impairment severe enough to prevent informed consent or completing the survey instruments
Exclusion Criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Early interventionEarly interventionThree sites received the Pain Management Support System for Primary Care (PMSS-PC) integrated into the Electronic Health Record.
Delayed interventionDelayed interventionDelayed wait-list control group. Three additional sites received the intervention 6 months after the first arm.
Primary Outcome Measures
NameTimeMethod
Worst Pain IntensityFrom baseline to 6 months following intervention implementation

Worst pain intensity score on the Brief Pain Inventory-Short Form. Scores range from 0-10, with higher scores indicating more severe worst pain intensity.

Pain Interference with FunctionFrom baseline to 6 months following intervention implementation

Pain interference T-score, measured on the PROMIS Pain Interference Short Form. Higher scores indicate more pain interference with function.

Average Pain IntensityFrom baseline to 6 months following intervention implementation

Average pain intensity score on the Brief Pain Inventory-Short Form. Scores range from 0-10, with higher scores indicating more severe average pain intensity.

Secondary Outcome Measures
NameTimeMethod
Worst Pain IntensityFrom 6 to 12 months following intervention implementation

Worst pain intensity score on the Brief Pain Inventory-Short Form. Scores range from 0-10, with higher scores indicating more severe worst pain intensity.

Average Pain IntensityFrom 6 to 12 months following intervention implementation

Average pain intensity score on the Brief Pain Inventory-Short Form. Scores range from 0-10, with higher scores indicating more severe average pain intensity.

Pain Interference with FunctionFrom 6 to 12 months following intervention implementation

Pain interference T-score, measured on the PROMIS Pain Interference Short Form. Higher scores indicate more pain interference with function.

Uptake of the PMSS-PC intervention toolFrom baseline to 12 months following intervention implementation

Use of the PMSS-PC decision support tool by primary care providers

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