Chronic Illness, Opioid Use, Palliative Care
Conditions
Keywords
pharmacogenomics
Brief summary
The investigators propose to study the feasibility, acceptability, usability and outcomes of a new clinical decision support system for clinicians of opioid therapy in the context of specialist palliative care for serious chronic illness. The system provides clinicians with patient-specific genetic information on opioid responsiveness and multi-drug interactions. This clinical decision support system should improve the clinician's ability to identify the optimal pain medication and dosage, and reduce risks associated with multi-drug treatment. Investigators will conduct clinician survey's to collection information about the clinical decision support system. Investigators will also conduct patient related questionnaires to determine any benefits or improvements in quality of life and symptom management from the clinical decision support system.
Interventions
The system provides clinicians with patient-specific genetic information on opioid responsiveness and multi-drug interactions. This clinical decision support system should improve the clinician's ability to identify the optimal pain medication and dosage, and reduce risks associated with multi-drug treatment.
Sponsors
Tabula Rasa HealthCare
Hospice of Henderson County, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Clinicians will be eligible if: 1. Physicians or nurse practitioners who are practicing hospice and palliative care 2. Responsible for making and implementing decisions about opioid therapy for pain Patients will be identified by their treating clinicians. Patients will be eligible if: 1. \> 18 years of age 2. Palliative Performance Score ≥ 30% 3. Reside in the community or at a nursing home 4. Have \>1 serious chronic illness 5. Have an assessed life-expectancy of at least 4 weeks 6. Have a history of pain and have been taking prescribed opioid medication with a regimen that provides a minimum dose of 20 mg morphine or equivalent per day in scheduled doses for at least one week prior to recruitment 7. Is expected to continue opioid therapy for the duration of study participation 8. Is taking \> 4 non-opioid medications, each in a regimen providing continuous treatment of pain or another disorder 9. Is expected to continue drug therapy for the duration of study participation 10. Able to read, understand, and provide Informed Consent to participate
Exclusion criteria
There are no
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinician Feasibility | through study completion, an average of 24 months | Clinical questionnaire to determine feasibility of the system |
| Clinician Usability | through study completion, an average of 24 months | Clinical questionnaire to determine usability of the system |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Quality of Life | through study completion,an average of 24 months | Functional Assessment of Chronic Illness - Palliative (FACIT-PAL) |
| Patient Pain | through study completion, an average of 24 months | Numerical Rating Scale to assess pain |
Countries
United States
Outcome results
None listed