Effects of a Patient Driven Assessment Process With Complex Pain Patients

Study Overview
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Brief Summary
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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.

Official Title
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Effects of a Patient Driven Assessment Process With Complex Pain Patients (PDAP)

Conditions
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Chronic Pain

Intervention / Treatment
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* Other: The MySupport tool


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: The MySupport tool<br>Utilization of the MySupport tool, a tailored patient-centered assessment | Other: The MySupport tool<br>* Utilization of the MySupport tool, a tailored patient-centered assessment<br>|
| No Intervention: Usual care<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain severity and functioning | Brief Pain Inventory (BPI-SF): pain severity and pain interference subscales | Change at 5 months, change from 5 to10 months and change at 10 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of sleep | Insomnia Severity Index | Change at 5 months, change from 5 to10 months and change at 10 months | 
| Patient skill in managing health care | Patient Activation Measure | Change at 5 months, change from 5 to10 months and change at 10 months | 
| Health-related quality of life | EuroQuol Instrument | Change at 5 months, change from 5 to10 months and change at 10 months | 
| Clinician empathy | CARE measure | Change at 5 months, change from 5 to10 months and change at 10 months | 
| Self-care practices | Questionnaire | Change at 5 months, change from 5 to10 months and change at 10 months | 
| Health services utilization | Electronic medical records | Change at 5 months, change from 5 to10 months and change at 10 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic Pain, Analgesics, Opioid, Primary Health Care