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BMC Medical Informatics and Decision Making

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01-12-2020 | Opioids | Research article

Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool

Authors: Nananda Col, Stephen Hull, Vicky Springmann, Long Ngo, Ernie Merritt, Susan Gold, Michael Sprintz, Noel Genova, Noah Nesin, Brenda Tierman, Frank Sanfilippo, Richard Entel, Lori Pbert

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

Abstract

Background

Chronic pain has emerged as a disease in itself, affecting a growing number of people. Effective patient-provider communication is central to good pain management because pain can only be understood from the patient’s perspective. We aimed to develop a user-centered tool to improve patient-provider communication about chronic pain and assess its feasibility in real-world settings in preparation for further evaluation and distribution.

Methods

To identify and prioritize patient treatment goals for chronic pain, strategies to improve patient-provider communication about chronic pain, and facilitate implementation of the tool, we conducted nominal group technique meetings and card sorting with patients with chronic pain and experienced providers (n = 12). These findings informed the design of the PainAPP tool. Usability and beta-testing with patients (n = 38) and their providers refined the tool and assessed its feasibility, acceptability, and preliminary impact.

Results

Formative work revealed that patients felt neither respected nor trusted by their providers and focused on transforming providers’ negative attitudes towards them, whereas providers focused on gathering patient information. PainAPP incorporated areas prioritized by patients and providers: assessing patient treatment goals and preferences, functional abilities and pain, and providing patients tailored education and an overall summary that patients can share with providers.

Beta-testing involved 38 patients and their providers. Half of PainAPP users shared their summaries with their providers. Patients rated PainAPP highly in all areas. All users would recommend it to others with chronic pain; nearly all trusted the information and said it helped them think about my treatment goals (94%), understand my chronic pain (82%), make the most of my next doctor’s visit (82%), and not want to use opioids (73%). Beta-testing revealed challenges delivering the tool and summary report to patients and providers in a timely manner and obtaining provider feedback.

Conclusions

PainAPP appears feasible for use, but further adaptation and testing is needed to assess its impact on patients and providers.

Trial registration

This study was approved by the University of New England Independent Review Board for the Protection of Human Subjects in Research (012616–019) and was registered with ClinicalTrials.gov (protocol ID: NCT03425266) prior to enrollment. The trial was prospectively registered and was approved on February 7, 2018.

Available only for authorised users

This response was: “We discuss my fibromyalgia pain and changes each appointment briefly”

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Title: Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool
Authors: Nananda Col
Stephen Hull
Vicky Springmann
Long Ngo
Ernie Merritt
Susan Gold
Michael Sprintz
Noel Genova
Noah Nesin
Brenda Tierman
Frank Sanfilippo
Richard Entel
Lori Pbert
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Opioids
Opioids
Published in: BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI: https://doi.org/10.1186/s12911-020-01279-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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