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Clinical efficacy and implementation issues of an electronic pain reporting device among outpatients with cancer
M Kay M Judge1,2, Roberta Luedke3, Brenda W Dyal4
1Nursing Consult LLC, 2125 First Ave #1802, Seattle, WA, 98121, USA. nursingconsultllc@gmail.com.
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.
