DESCRIPTION (provided by applicant): Unrelieved cancer pain is a major health problem. We propose a study testing PAINRelieveIt, a computerized set o tools with pain report scales, decision support for providers and multimedia education customized to the needs of the individual cancer patient. The study will be a randomized clinical trial in outpatients receiving treatments at the UW/Seattle Cancer Care Alliance using a pre-test/post-test design to compare effects of usual-care and the computerized tool on pain outcomes. PAINRelieveIt includes electronic versions of valid and reliable scales for pain (PAINReportlt), a printed summary of the patient's pain data with decision support for providers to prescribe algorithm-based analgesic therapies (PAINConsultN), and computerized multimedia education customized to dress the patient s pain management needs (PainUCope). PAINReleiveIt allows patients to describe their pain sing PAINReportIt and touch-screen technology. Answers are automatically stored in an electronic database, which is then used to generate PAINConsultN and PainUCope. Post-test outcome measures will be obtained 4- weeks after the intervention at the time peak treatment-related pain is predicted. Specific aims are to: 1) Compare
usual-care and PAINRelieveIt for effects on patient outcomes (pain intensity, satisfaction with pain intensity, misconceptions about pain) in a diverse sample of 300 persons with advanced stage cancer and receiving radiation or chemotherapy and 2) Compare usual-care and PAINRelieveIt for effects on provider outcomes (number of recommended prescriptions , appropriateness of analgesics prescribed; clinic visit length) in a sample of radiation and medical oncologists. We hypothesize that at 4,weeks and controlling for baseline data, the clinic visit length will be similar for the two groups but that the computerized PAINRelievelt group will report: a) decreased scores for the current and worst pain intensity and misconceptions about pain; and b) increased level of satisfaction with pain intensity, number of recommended and cancer pain guideline-appropriate analgesic prescriptions. Patients will either complete usual assessments or PAINRelieveIt. In the experimental group, the PAINReportIt data will be used to provide clinicians with an algorithm-based list of analgesics that may be useful for improved pain control and a summary of the pain data. Additionally, in the experimental group, patients will view multimedia education via the PAINUCope program, which tailors the content to the patient's beliefs and attitudes about pain. Four weeks after the pre-test, patients will complete PAINReportIt to document outcomes. Study findings will guide future studies implementing the PAINRelieveIt program in multisite, longitudinal trial that will test the effect of this new candor control technology on pain management in a national sample of cancer patients.
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