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Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool
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 patie...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568350/ https://www.ncbi.nlm.nih.gov/pubmed/33069228 http://dx.doi.org/10.1186/s12911-020-01279-8 |
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author | Col, Nananda Hull, Stephen Springmann, Vicky Ngo, Long Merritt, Ernie Gold, Susan Sprintz, Michael Genova, Noel Nesin, Noah Tierman, Brenda Sanfilippo, Frank Entel, Richard Pbert, Lori |
author_facet | Col, Nananda Hull, Stephen Springmann, Vicky Ngo, Long Merritt, Ernie Gold, Susan Sprintz, Michael Genova, Noel Nesin, Noah Tierman, Brenda Sanfilippo, Frank Entel, Richard Pbert, Lori |
author_sort | Col, Nananda |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7568350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75683502020-10-20 Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool Col, Nananda Hull, Stephen Springmann, Vicky Ngo, Long Merritt, Ernie Gold, Susan Sprintz, Michael Genova, Noel Nesin, Noah Tierman, Brenda Sanfilippo, Frank Entel, Richard Pbert, Lori BMC Med Inform Decis Mak Research Article 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. BioMed Central 2020-10-17 /pmc/articles/PMC7568350/ /pubmed/33069228 http://dx.doi.org/10.1186/s12911-020-01279-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Col, Nananda Hull, Stephen Springmann, Vicky Ngo, Long Merritt, Ernie Gold, Susan Sprintz, Michael Genova, Noel Nesin, Noah Tierman, Brenda Sanfilippo, Frank Entel, Richard Pbert, Lori Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title | Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title_full | Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title_fullStr | Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title_full_unstemmed | Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title_short | Improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
title_sort | improving patient-provider communication about chronic pain: development and feasibility testing of a shared decision-making tool |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568350/ https://www.ncbi.nlm.nih.gov/pubmed/33069228 http://dx.doi.org/10.1186/s12911-020-01279-8 |
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