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Clinical efficacy and implementation issues of an electronic pain reporting device among outpatients with cancer

Abstract

Purpose

Collecting patients’ pain features for congruent pain relief treatment is time-consuming. We sought to identify implementation issues and evaluate the efficacy of an electronic patient self-reporting pain device in community-based cancer clinics.

Methods

In a 2-phase descriptive pilot and randomized controlled trial (RCT) with pretest/posttest design, 178 cancer patients participated (n = 33 pilot phase; n = 145 in the RCT phase). Patients completed PAINReportIt®, an electronic version of the valid and reliable McGill Pain Questionnaire that comprehensively measures the multiple dimensions of pain. All pilot phase and RCT patients were asked to complete PAINReportIt® twice and received usual care. For RCT patients assigned to the experimental group, a copy of the PAINReportIt® Summary was placed in their clinic medical record before they visited their clinicians. Posttest measures were completed 3–7 days later.

Results

We identified three implementation barriers: system resistance to deposit of research data into the medical record, staff resistance to change, and patients’ physical manipulation of the tablet. The time required to complete the tool did not differ significantly between groups but reduced significantly pre- to posttest in both RCT groups. Current pain intensity and pain quality but not worst pain scores decreased significantly pre- to posttest in the experimental group. None of the pain variables differed significantly between groups.

Conclusion

Implementation of PAINReportIt® was feasible in community oncology clinic settings. Barriers identified were expected and were surmountable. The studied tool showed satisfactory time sparing for comprehensive pain assessment with data automatically recorded and easily accessed by the clinician in the form of a summary report. Findings support the need for additional research to demonstrate the clinical efficacy of tablet-based pain assessment on patient outcomes as well as clinical care processes such as pain documentation and analgesic prescriptions.

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Funding

The research was supported in part by Grant Number R44 NR04742, National Institute of Nursing Research, National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Nursing Research.

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Affiliations

Authors

Contributions

MKMJ, DW made substantial contributions to the conception and design of the work; analysis, or interpretation of data; and the creation of new software used in the work.

MKM, RL contributed to data acquisition.

MKMJ, DW, RL, BD, MOE drafted the work or revised it critically for important intellectual content.

MKMJ, DW, RL, BD, MOE approved the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to M. Kay M. Judge.

Ethics declarations

Ethics approval

The Institutional Review Boards at the University of Washington and the community medical center approved the study.

Consent to participate/consent to publish

Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data.

Conflict of interest

The final peer-reviewed manuscript is subject to the NIH Public Access Policy. PAINReportIt® is owned by Nursing Consult, LLC, a company in which M. Kay M Judge owns shares.

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Cite this article

Judge, M.K.M., Luedke, R., Dyal, B.W. et al. Clinical efficacy and implementation issues of an electronic pain reporting device among outpatients with cancer. Support Care Cancer 29, 5227–5235 (2021). https://doi.org/10.1007/s00520-021-06075-2

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Keywords

  • Cancer pain
  • Pain measurement
  • Community health center