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Information about ongoing health services research and public health projects

Measuring the context of healing: using PROMIS in chronic pain treatment
Investigator (PI): Greco, Carol
Performing Organization (PO): (Current): University of Pittsburgh, School of Medicine, Department of Psychiatry / (412) 246-6784
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/ME-1402-10114
Funding: Total Award Amount: $728,340
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Questions such as who improves with treatment, which treatments are most appropriate for whom, and whether patients' perceptions influence outcomes are highly relevant to patients and clinicians in making healthcare decisions. However, in most research studies, such questions are not addressed. This project focuses on these questions and will contribute to the understanding of treatment outcome differences based upon patients' views of themselves and their treatment. The project uses assessment instruments, computerized adaptive tests (CATs), from the Patient-Reported Outcomes Measurement Information System (PROMIS[R]). Our research team has recently developed and tested (using PROMIS methods) a new set of instruments to assess non-specific factors in healing from the patient's perspective. These instruments, the Healing Encounters and Attitudes Lists (HEAL) assess the Patient-Provider Connection, Treatment Expectancy, views of the Healthcare Environment, Positive and Negative Attitudes, Spirituality, and Attitude toward Complementary and Alternative Medicine (CAM). HEAL CATs, like other PROMIS CATs, are brief, easy to use and understand, and are designed to apply to a broad spectrum of treatments and health conditions. In this project, we aim to 1) evaluate whether the HEAL CATs predict chronic pain treatment outcomes; 2) examine heterogeneity of treatment effects based upon HEAL and PROMIS scores in integrative and conventional medicine settings; and 3) interview patients and their clinicians regarding the utility of HEAL, PROMIS, and a Pain Log for enhancing communication. We will administer HEAL CATs and other PROMIS CATs (depression, anxiety, sleep disturbance, fatigue and physical function) to 200 patients who are starting treatment for chronic pain in integrative medicine and conventional medicine settings. Follow-up assessments will be completed 2 and 4 months after baseline testing. We will evaluate factors that may predict which patients judge themselves to be improved, the same, or worsened. Some of the possible factors that may contribute to improvement include HEAL scores, emotional distress at baseline, or the preference for CAM or conventional treatment. We are also interested in learning whether patients find the assessments to be clear and useful. A subset of 50 patients and approximately 10 clinicians will complete interviews about the HEAL and PROMIS questions, and about the Pain Log developed by our patient advocacy group partner, the American Chronic Pain Association. By interviewing patients and their healthcare providers we hope to determine the clarity and acceptability of the HEAL and other assessments, and to learn whether they enhance patient-provider communication in the clinical partnership.
MeSH Terms:
  • Anxiety /complications
  • Chronic Pain /*therapy
  • Communication
  • Complementary Therapies /methods
  • Data Collection
  • Depression /complications
  • Fatigue
  • Humans
  • * Outcome Assessment, Health Care
  • Pain Management /*methods
  • Patient Participation
  • Patient-Centered Care /*methods
  • Professional-Patient Relations
  • Program Development
  • Program Evaluation
  • United States
Country: United States
State: Pennsylvania
Zip Code: 15213
UI: 20152286
CTgovId: NCT02873429
Project Status: Completed
Record History: ('2018: Project extended to 2018. 2017: Project extended to 2017.',)