Chronic Pain
Conditions
Keywords
Chronic Pain, Analgesics, Opioid, Primary Health Care
Brief summary
The objective of this study is to engage patients with chronic pain and other key stakeholders in an iterative process of pilot-testing a validated patient generated instrument, the Measure Yourself Medical Outcome Profile (MYMOP), to support primary care encounters and provide a direct comparison between a strategy of incorporating patient reported outcomes into the package of care for complex pain patients and usual care. The specific aims of this phase of the project are to: 1) adapt the MYMOP for use in the primary care setting well-integrated into everyday practice flow, and 2) evaluate whether the utilization of the MYMOP data in routine primary care encounters results in improvements in patient symptoms and functioning over time as well as increased satisfaction with the visit for patients and primary care providers. To achieve Aim 2, the investigators will compare the reported outcomes and health care utilization from participating patients in this study for whom the MYMOP-based instrument will be used in routine clinical care to a matched group of chronic pain patients who will not receive the MYMOP-based assessment but will otherwise have similarly collected data. This also allows us to evaluate of the extent to which use of the tool adds patient-centered information to more conventional instruments. In addition to these two aims, for a third aim, the investigators plan to collect qualitative data from patients, their family members, Kaiser Permanente Northwest (KPNW) health care providers, and KPNW administrators to better understand the needs of this subpopulation of patients.
Interventions
OTHERThe MySupport tool
Utilization of the MySupport tool, a tailored patient-centered assessment
Sponsors
Kaiser Permanente
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years or older * Kaiser Permanente Northwest health plan members with at least 12 months of continuous eligibility at time of study entry and receive primary care from participating physicians * Continued opioid use during the previous 6 months, as defined by 2 or more dispenses of long-acting opioids and/or a minimum cumulative supply of 90 days' worth of short-acting opioids based on electronic medical record (EMR) d) EMR recorded diagnosis of nonspecific chronic pain, Fibromyalgia, or diagnosis of ≥ 2 types of pain in the past year
Exclusion criteria
* Active cancer * Substance abuse or dependence * Hospice care * Severe mental illness
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain severity and functioning | Change at 5 months, change from 5 to10 months and change at 10 months | Brief Pain Inventory (BPI-SF): pain severity and pain interference subscales |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient skill in managing health care | Change at 5 months, change from 5 to10 months and change at 10 months | Patient Activation Measure |
| Health-related quality of life | Change at 5 months, change from 5 to10 months and change at 10 months | EuroQuol Instrument |
| Quality of sleep | Change at 5 months, change from 5 to10 months and change at 10 months | Insomnia Severity Index |
| Self-care practices | Change at 5 months, change from 5 to10 months and change at 10 months | Questionnaire |
| Health services utilization | Change at 5 months, change from 5 to10 months and change at 10 months | Electronic medical records |
| Clinician empathy | Change at 5 months, change from 5 to10 months and change at 10 months | CARE measure |
Countries
United States
Outcome results
None listed