Incorporating Patient Preferences into Decisions about Chronic Pain Management

We seek to understand the preferences, goals, and perspectives of patients with chronic pain and their health care providers (HCPs) to create a patient-centered decision support tool. This tool, aimed at patients and HCPs, should improve patient-provider communication and chronic pain management. Our long-term goal is to improve the quality of life of patients with chronic pain. We target adults with chronic unremitting pain and HCPs who manage patients with chronic pain, including primary care providers and pain specialists.

We propose to develop a shared decision making (SDM) platform, Pain-APP (Assessing Patient Preferences) that will assess a patient’s level of pain, preferences, and concerns and communicate these to their HCPs using individualized SDM reports. The SDM platform should improve patientprovider communication and decisions about pain treatment plans by stimulating and facilitating dialogue. We will assess patient and HCP preferences using a cognitive mapping approach, including nominal group technique (NGT) meetings, and use these findings to develop the SDM tool. Formative evaluation will include usability testing and beta-testing with approximately 35 patients and HCPs. We will then measure the impact of the platform on patient-provider communication, pain, and physical function in a randomized, controlled trial (n=50). Because this project is nested within a larger vision for improving the pain management, it is likely to be adopted throughout the state of Maine as part of a new pain management policy; funding from a PCORI grant (under review) will enable us to further measure its impact longitudinally in a comparative effectiveness trial.