Pain Assessment Interview and Clinical Advisory System

DESCRIPTION (provided by applicant): This application builds on programmatic research at Inflexxion to develop the PAIN Clinical Advisory System (PAIN-CAS), a systematic and validated assessment of pain patients along with provider reports containing treat ment recommendations and patient feedback reports. Such a pain management resource, with up-to-date specific information about patients' health status, would allow a physician to maximize the available time in an encounter while minimizing potential advers e impacts of treatment, such as addiction to analgesics. Chronic pain is a costly syndrome that influences every aspect of a person's functioning. Treatment of chronic pain, by definition, regularly addresses complicated clinical presentations, including c omorbid medical conditions, psychiatric problems, and perhaps uniquely, substance abuse potential. Despite this complexity, treatment decisions are based on ever-briefer clinic encounters that are increasingly conducted by non-specialists. This tends to re sult in an over-focus on medical interventions and insufficient emphasis on (seemingly) unrelated psychosocial issues that may exacerbate pain. Patients and providers alike are frustrated by pain symptoms requiring repeated visits that yield limited improv ement. The proposed PAIN-CAS utilizes Inflexxion's expertise in applying technology to address healthcare problems in an effort to impact how pain management is conducted. Key features of PAIN-CAS include: (1) Patient Assessment Module/Intake and Follow-up Assessments, which will assess pain, substance use, psychiatric status, and comorbid physical conditions, along with screening for addiction potential and monitoring of medication misuse and abuse. The assessment component will be designed to be easily co mpleted by the large number of illiterate patients in the US. (2) Provider Reports will include an Intake Report, complete with treatment recommendations, and a Follow-up Visit Report. (3) A patient feedback report, tailored to patients' responses to the a ssessments, will be designed to enhance patient empowerment and to encourage active participation and cooperation with treatment. Finally, (4) an Online Tool Kit will allow providers to upload confidential, HIPAA compliant data from their clinic and examin e their own aggregate data and compare these data with uniform aggregate data collected at other participating clinics around the country. In collaboration with an Expert Advisory Panel, Inflexxion will achieve an ambitious series of goals in Phase I, incl uding (1) creation of sample report formats for provider and patient output of the PAIN-CAS, (2) creation of pain treatment algorithms to be programmed into the system, (3) outline of the functionality of the Online Tool Kit, (4) creation of a flowchart an d outline of PAIN-CAS assessments, (5) creation and testing of a demonstration program, (6) creation of a Technical Brief for the PAIN-CAS program, and (7) completion of satisfaction and acceptance studies of the PAIN-CAS components with providers and pain patients. The proposed PAIN-CAS potentially addresses limitations of existing efforts to enhance assessment and practice in the treatment of chronic pain. Project Narrative: As society increasingly demands that medical professionals address the complex cl inical presentations of patients with chronic pain, it is increasingly important that providers have the benefit of standardized computer- administered assessments along with computerized treatment recommendations. Successful development and dissemination of a comprehensive, integrated PAIN Clinical Advisory System (PAIN-CAS) will go some distance toward enhancing assessment and treatment of chronic pain and be perceived as highly valuable to stakeholders. Thus, we believe this product has enormous commerci al viability and public health importance.