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Published in: Translational Behavioral Medicine 2/2014

01-06-2014 | Original Research

Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care

Authors: Lindsey M Dorflinger, PhD, Wesley P Gilliam, PhD, Allison W Lee, MPH, Robert D Kerns, PhD

Published in: Translational Behavioral Medicine | Issue 2/2014

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ABSTRACT

Chronic pain is one of the most common presenting problems in primary care. Standards and guidelines have been developed for managing chronic pain, but it is unclear whether primary care providers routinely engage in guideline-concordant care. The purpose of this study is to develop a tool for extracting information about the quality of pain care in the primary care setting. Quality indicators were developed through review of the literature, input from an interdisciplinary panel of pain experts, and pilot testing. A comprehensive coding manual was developed, and inter-rater reliability was established. The final tool consists of 12 dichotomously scored indicators assessing quality and documentation of pain care in three domains: assessment, treatment, and reassessment. Presence of indicators varied widely. The tool is reliable and can be utilized to gather valuable information about pain management in the primary care setting.
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Literature
1.
go back to reference Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. J Rehabil Res Dev. 2003; 40: 371-379.PubMedCrossRef Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. J Rehabil Res Dev. 2003; 40: 371-379.PubMedCrossRef
2.
go back to reference Haskell SG, Heapy A, Reid MC, Papas RK, Kerns RD. The prevalence and age-related characteristics of pain in a sample of women veterans receiving primary care. J Womens Health (Larchmt). 2006; 15: 862-869.CrossRef Haskell SG, Heapy A, Reid MC, Papas RK, Kerns RD. The prevalence and age-related characteristics of pain in a sample of women veterans receiving primary care. J Womens Health (Larchmt). 2006; 15: 862-869.CrossRef
3.
go back to reference Reid MC, Engles-Horton LL, Weber MB, Kerns RD, Rogers EL, O'Connor PG. Use of opioid medications for chronic noncancer pain syndromes in primary care. J Gen Intern Med. 2002; 17: 173-179.PubMedCentralPubMedCrossRef Reid MC, Engles-Horton LL, Weber MB, Kerns RD, Rogers EL, O'Connor PG. Use of opioid medications for chronic noncancer pain syndromes in primary care. J Gen Intern Med. 2002; 17: 173-179.PubMedCentralPubMedCrossRef
4.
go back to reference Upshur CC, Luckmann RS, Savageau JA. Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006; 21: 652-655.PubMedCentralPubMedCrossRef Upshur CC, Luckmann RS, Savageau JA. Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006; 21: 652-655.PubMedCentralPubMedCrossRef
5.
go back to reference Tsang AM, Von Korff S, Lee J, et al. Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. J Pain. 2008; 9: 883-891.PubMedCrossRef Tsang AM, Von Korff S, Lee J, et al. Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. J Pain. 2008; 9: 883-891.PubMedCrossRef
6.
go back to reference Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies; 2011. Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies; 2011.
7.
go back to reference Cleeland CS, Reyes-Gibby CC, Schall M, et al. Rapid improvement in pain management: the Veterans Health Administration and the institute for healthcare improvement collaborative. Clin J Pain. 2003; 19: 298-305.PubMedCrossRef Cleeland CS, Reyes-Gibby CC, Schall M, et al. Rapid improvement in pain management: the Veterans Health Administration and the institute for healthcare improvement collaborative. Clin J Pain. 2003; 19: 298-305.PubMedCrossRef
8.
go back to reference Kirshbaum M. The development, implementation and evaluation of guidelines for the management of breast cancer related to lymphoedema. Eur J Cancer Care. 1996; 5: 246-251.CrossRef Kirshbaum M. The development, implementation and evaluation of guidelines for the management of breast cancer related to lymphoedema. Eur J Cancer Care. 1996; 5: 246-251.CrossRef
9.
go back to reference Aucott JN, Pelecanos E, Dombrowski R, Fuehrer SM, Laich J, Aron DC. Implementation of local guidelines for cost-effective management of hypertension. J Gen Intern Med. 1996; 11: 139-146.PubMedCrossRef Aucott JN, Pelecanos E, Dombrowski R, Fuehrer SM, Laich J, Aron DC. Implementation of local guidelines for cost-effective management of hypertension. J Gen Intern Med. 1996; 11: 139-146.PubMedCrossRef
10.
go back to reference Nardella A, Pechet L, Snyder LM. Continuous improvement, quality control, and cost containment in clinical laboratory testing. Effects of establishing and implementing guidelines for preoperative tests. Arch Pathol Lab Med. 1995; 119: 518-522.PubMed Nardella A, Pechet L, Snyder LM. Continuous improvement, quality control, and cost containment in clinical laboratory testing. Effects of establishing and implementing guidelines for preoperative tests. Arch Pathol Lab Med. 1995; 119: 518-522.PubMed
11.
go back to reference Krebs EE, Bair MJ, Carey TS, et al. Documentation of pain care processes does not accurately reflect pain management delivered in primary care. J Gen Intern Med. 2010; 25: 194-199.PubMedCentralPubMedCrossRef Krebs EE, Bair MJ, Carey TS, et al. Documentation of pain care processes does not accurately reflect pain management delivered in primary care. J Gen Intern Med. 2010; 25: 194-199.PubMedCentralPubMedCrossRef
12.
go back to reference Corson K, Doak MN, Denneson L, et al. Primary care clinician adherence to guidelines for the management of chronic musculoskeletal pain: results from the study of the effectiveness of a collaborative approach to pain. Pain Med. 2011; 12: 1490-1501.PubMedCrossRef Corson K, Doak MN, Denneson L, et al. Primary care clinician adherence to guidelines for the management of chronic musculoskeletal pain: results from the study of the effectiveness of a collaborative approach to pain. Pain Med. 2011; 12: 1490-1501.PubMedCrossRef
13.
go back to reference Sellinger J, Wallio S, Clark EA, Kerns RD. Comprehensive pain assessment: integration of biopsychosocial principles. In: Ebert MH, Kerns RD, eds. Behavioral and psychopharmacologic pain management. London: Cambridge University; 2011. Sellinger J, Wallio S, Clark EA, Kerns RD. Comprehensive pain assessment: integration of biopsychosocial principles. In: Ebert MH, Kerns RD, eds. Behavioral and psychopharmacologic pain management. London: Cambridge University; 2011.
14.
go back to reference Management of Opioid Therapy for Chronic Pain Working Group. VA/DoD clinical practice guideline for management of opioid therapy for chronic pain. Washington, DC: Department of Veterans Affairs, Department of Defense; 2010. Management of Opioid Therapy for Chronic Pain Working Group. VA/DoD clinical practice guideline for management of opioid therapy for chronic pain. Washington, DC: Department of Veterans Affairs, Department of Defense; 2010.
15.
go back to reference Institute for Clinical Systems Improvement. Assessment and management of chronic pain. Bloomington: Institute for Clinical Systems Improvement; 2011. Institute for Clinical Systems Improvement. Assessment and management of chronic pain. Bloomington: Institute for Clinical Systems Improvement; 2011.
16.
go back to reference Lorenz KA, Dy SM, Naeim A, et al. Quality measures for supportive cancer care: the Cancer Quality-ASSIST Project. J Pain Symptom Manag. 2009; 37: 943-964.CrossRef Lorenz KA, Dy SM, Naeim A, et al. Quality measures for supportive cancer care: the Cancer Quality-ASSIST Project. J Pain Symptom Manag. 2009; 37: 943-964.CrossRef
17.
go back to reference Gearing RE, Mian IA, Barber J, et al. A methodology for conducting retrospective chart review research in child and adolescent psychiatry. Can Acad Child Adolesc Psychiatry. 2006; 15: 126-134. Gearing RE, Mian IA, Barber J, et al. A methodology for conducting retrospective chart review research in child and adolescent psychiatry. Can Acad Child Adolesc Psychiatry. 2006; 15: 126-134.
18.
go back to reference Kergoat MJ, Leclerc BS, Leduc N, et al. Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition. BMC Geriatr. 2009; 9: 34.PubMedCentralPubMedCrossRef Kergoat MJ, Leclerc BS, Leduc N, et al. Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition. BMC Geriatr. 2009; 9: 34.PubMedCentralPubMedCrossRef
19.
go back to reference Matthias MS, Bair MJ, Nyland KA, et al. Self-management support and communication from nurse care managers compared with primary care physicians: a focus group study of patients with chronic musculoskeletal pain. Pain Manag Nurs. 2010; 11: 26-34.PubMedCrossRef Matthias MS, Bair MJ, Nyland KA, et al. Self-management support and communication from nurse care managers compared with primary care physicians: a focus group study of patients with chronic musculoskeletal pain. Pain Manag Nurs. 2010; 11: 26-34.PubMedCrossRef
20.
go back to reference Matthias MS, Parpart AL, Nyland KA, et al. The patient-provider relationship in chronic pain care: providers' perspectives. Pain Med. 2010; 11: 1688-1697.PubMedCrossRef Matthias MS, Parpart AL, Nyland KA, et al. The patient-provider relationship in chronic pain care: providers' perspectives. Pain Med. 2010; 11: 1688-1697.PubMedCrossRef
21.
go back to reference Chodosh J, Solomon DH, Roth CP, et al. The quality of medical care provided to vulnerable older patients with chronic pain. J Am Geriatr Soc. 2004; 52: 756-761.PubMedCrossRef Chodosh J, Solomon DH, Roth CP, et al. The quality of medical care provided to vulnerable older patients with chronic pain. J Am Geriatr Soc. 2004; 52: 756-761.PubMedCrossRef
22.
go back to reference Lorig KR, Ritter PL, Laurent DD, et al. Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions. Med Care. 2004; 42: 346-354.PubMedCrossRef Lorig KR, Ritter PL, Laurent DD, et al. Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions. Med Care. 2004; 42: 346-354.PubMedCrossRef
23.
go back to reference Buchbinder R. Self-management education en masse: effectiveness of the Back Pain: Don't Take It Lying Down mass media campaign. Med J Aust. 2008; 189: S29-S32.PubMed Buchbinder R. Self-management education en masse: effectiveness of the Back Pain: Don't Take It Lying Down mass media campaign. Med J Aust. 2008; 189: S29-S32.PubMed
24.
go back to reference de Jong JR, Vlaeyen JW, Onghena P, et al. Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clin J Pain. 2005; 21: 9-17.PubMedCrossRef de Jong JR, Vlaeyen JW, Onghena P, et al. Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clin J Pain. 2005; 21: 9-17.PubMedCrossRef
25.
26.
27.
go back to reference Luck J, Peabody JW, Dresselhaus TR, et al. How well does chart abstraction measure quality? A prospective comparison of standardized patients with the medical record. Am J Med. 2000; 108: 642-649.PubMedCrossRef Luck J, Peabody JW, Dresselhaus TR, et al. How well does chart abstraction measure quality? A prospective comparison of standardized patients with the medical record. Am J Med. 2000; 108: 642-649.PubMedCrossRef
28.
go back to reference Tisnado DM, Adams JL, Liu H, et al. What is the concordance between the medical record and patient self-report as data sources for ambulatory care? Med Care. 2006; 44: 132-140.PubMedCrossRef Tisnado DM, Adams JL, Liu H, et al. What is the concordance between the medical record and patient self-report as data sources for ambulatory care? Med Care. 2006; 44: 132-140.PubMedCrossRef
Metadata
Title
Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care
Authors
Lindsey M Dorflinger, PhD
Wesley P Gilliam, PhD
Allison W Lee, MPH
Robert D Kerns, PhD
Publication date
01-06-2014
Publisher
Springer US
Published in
Translational Behavioral Medicine / Issue 2/2014
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-014-0260-5

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