Measuring the Context of Healing: Using PROMIS in Chronic Pain Treatment
Background: Questions such as who improves with treatment, which treatments are most appropriate for whom, and do patients’ perceptions influence outcomes, are highly relevant to patients and clinicians in making healthcare decisions. However, in most research studies, such questions are not addressed. This project focuses on these questions and will contribute to the understanding of treatment outcome differences based upon patients’ views of themselves and their treatment.
Methods: We will administer Healing Encounters and Attitudes Lists (HEAL) and other Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests (CATs) to 200 patients who are starting treatment for chronic pain in integrative medicine and conventional medicine settings. Follow-up assessments will be completed two and four months after baseline testing.
Objectives: We aim to:
- Evaluate whether the HEAL CATs predict chronic pain treatment outcomes
- Examine heterogeneity of treatment effects based on HEAL and PROMIS scores in integrative and conventional medicine settings
- Interview patients and their clinicians regarding the utility of HEAL, PROMIS, and a pain log for enhancing communication.
Patient Outcomes: We will evaluate factors that may predict which patients judge themselves to be improved, the same, or worsened. Some of the possible factors that may contribute to improvement include HEAL scores, emotional distress at baseline, or the preference for complementary and alternative medicine or conventional treatment. We are also interested in learning whether patients find the assessments to be clear and useful. A subset of 50 patients and approximately 10 clinicians will complete interviews about HEAL and PROMIS questions, and about the pain log developed by our patient advocacy group partner, the American Chronic Pain Association.
Anticipated Impact: By interviewing patients and their healthcare providers, we hope to determine the clarity and acceptability of HEAL and other assessments and to learn whether they enhance patient-provider communication in the clinical partnership.