A Multidimensional Pain Assessment Tool for Primary Care

DESCRIPTION (provided by applicant): Experts recognize that the proper assessment and treatment of pain should extend beyond the biological injury to include more complex multidimensional variables. These variables include patient expectations, impact on quality of life, beliefs, prior experiences, and social and recreational variables. Research indicates that pain related outcomes are improved if the whole person is treated instead focusing only on the physiological process. In spite of the acknowledgement of the benefits of multidimensional pain assessment and treatment, significant conceptual and practical barriers remain. The disparity between state-of-the-art knowledge and clinical practice accentuates the need for strategies and tools to help bridge this gap. Primary care providers, in the frontline of pain management, are particularly in need of tools to improve care and efficiency as they are increasingly asked to provide more care with limited resources. In order to help bridge the gap between conceptual understanding of pain management and delivered care in the primary care setting, we developed a pilot version of a computerized assessment and feedback tool that provides multidimensional pain evaluation and treatment advice. We conducted pilot studies with both primary care providers and chronic pain patients. Results indicated that both patients and providers found the MPAT tool to be a useful and functional piece of software. Feedback from providers about report types and features will be used to further develop the Phase II product. We propose (in Phase II) to extend the MPAT reporting tool to include a wider range of assessment measures and to further develop our software to allow for more complex data analysis and synthesis. We will also create a clinician and patient website to improve efficacy of report generation, and from which providers can access a tutorial that presents the theoretical rationale for the product, training to use the MPAT, educational handouts for chronic pain patients, and from which patients can access brief, didactic information for patients about non-pharmacological treatment of pain. In the project's second year, we will conduct a utility study with a sample of primary care providers and their chronic pain patients to examine changes in patient mood, activity, and pain ratings, as well as to investigate the usability and utility of the MPAT Phase II system in a real world setting.