Integrating the Patient Voice into a Comparative Effectiveness Trial of Communication Strategies in the Management of Chronic Pain
- Penney Cowan, Founder & CEO, American Chronic Pain Association
- Tom Norris, Chronic Pain Patient & Chronic Pain Patient Advocate
Other Stakeholder Partners
- Consumer Reports Health
- ABIM Foundation
In the past decade, the use of opioids (such as Vicodin® and Percocet®) for chronic pain has increased at an alarming rate. The highly addictive nature of opioids and their resulting overuse has resulted in a public health crisis in the United States. Overdose deaths from opioids now outnumber deaths from heroin and cocaine combined. It is vital to address the problem of opioid overprescribing in a way that maximizes benefits for patients while minimizing harms. As policy makers and medical societies devise strategies that stem opioid overuse, it is vital to incorporate the patient perspective into these discussions.
Many studies show that patients and physicians often do not have the same expectations about treating chronic pain. These conflicting expectations make it challenging for patients, their families, and their physicians to discuss the risks and benefits of opioid medications and their alternatives. In this study, we are using the latest computer technologies to deliver and compare two communication strategies at the point of care to help patients and their doctors have better discussions about opioids. In this study, we are comparing the use of patient education and engagement materials about pain management administered through the electronic health record’s patient portal versus computerized reminders for doctors about when opioids are appropriate. We are following patients over a one-year period to see if implementing these communication strategies can ultimately result in lowering the impact of pain on people’s lives while avoiding adverse consequences of reducing opioids. We are also assessing which strategy helps improve overall quality of life for patients as well as which strategy helps reduce prescribing practices that may endanger patients, such as high-dose opioid prescriptions or mixing opioids with other medications that may be unsafe.
To accomplish our goal of improving communication and outcomes for patients with chronic pain, we are collaborating with many patient partners, including a patient advocate who has a chronic pain condition, the American Chronic Pain Association, and Consumer Reports—a major consumer advocacy organization with enormous reach to disseminate the results of our work. We are also working closely with primary care doctors to ensure that their perspectives are incorporated into this research. Our stakeholders were instrumental in the selection of the study design and its outcomes. We will continue to collaborate with our patient partners throughout the course of the study and will work together to find the best ways to disseminate our results. By working closely with our patient partners and stakeholders, we hope to learn how patients, doctors, and healthcare systems can implement the most effective communication strategy to address chronic pain treatment and management.
*All proposed projects are approved subject to a programmatic and budgetary review by PCORI, and the acceptance of PCORI’s contract terms and conditions.