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Assessing pain level in the clinic: An introduction to the e/Tablet system

Assessing pain level in the clinic: An introduction to the e/Tablet system. Alexandra Dupont Cancer Pain Symposium June 6, 2008. NCCN Pain Practice Guidelines. Screen for pain at each visit If pain is present… Quantify pain intensity

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Assessing pain level in the clinic: An introduction to the e/Tablet system

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  1. Assessing pain level in the clinic: An introduction to the e/Tablet system Alexandra Dupont Cancer Pain Symposium June 6, 2008

  2. NCCN Pain Practice Guidelines • Screen for pain at each visit • If pain is present… • Quantify pain intensity • Ask patient to describe characteristics of pain (ie. aching, burning, etc) • Severe uncontrolled pain is a medical emergency and should be evaluated promptly • Variety of screening tools

  3. e/Tablets

  4. e/Tablet Basics • PACE™ system • Patient Assessment Care and Education • Supportive Oncology Services, Inc. (Memphis, TN) • Maintained on a server behind Duke firewall • HIPPA-compliant • Back-up copies of the database are maintained through the CCIT group

  5. Programmed a menu of well-validated questionnaires that would be credible in any cancer research study (e.g. FACT-B, MDASI)

  6. Adapted the PACETM System • Developed in the community oncology setting • Review of systems data and practice efficiency

  7. Patient Care Monitor (PCM) • 86 questions for women, 80 for men • Review of Systems • Psychological component • Previously validated • Pain specific questions • How bad if at all as the following been a problem over the past week, including today? • Physical pain • Headache • Chest pain • Menstrual pain/cramping • Joint pain • Burning in hands/feet • Numbness/tingling • Physical Functioning (eg. sit up, walk, bathe or dress, stay out of bed)

  8. Clinical Benefits • Real-time monitoring • Provider receives report before seeing patient • Private environment for answering honestly • Patient reported outcomes in research • Symptom tracking • Colorcoding •  indicate symptom increase or decrease • 4 time points • Distress and despair t-scores

  9. Dates – Current and first PCMs Arrows indicating symptom change T-scores

  10. Clinical Benefits • Whole person model • Source of pain (physical vs. psychological) • Related issues • Patient and caregiver education • Documentation • Encourages discussion with patient • Can use it in recorded summary of visit

  11. Matched to clinical tools and efficiencies that attract patient interest

  12. Future Directions • Warehouse data • Look at pain as a multimodal symptom • Integrate new PRO technology into all clinics • Understand pain in context of individual cancer types Use technology to work smarter, not harder

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