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Can Assessing Chronic Pain Outcomes Data Improve Outcomes?

Authors

  • Lisa R. Witkin MD,

    1. Penn Pain Medicine Center, Department of Anesthesiology and Critical Care, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • John T. Farrar MD, PhD,

    1. Penn Pain Medicine Center, Department of Anesthesiology and Critical Care, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Michael A. Ashburn MD, MPH

    Corresponding author
    • Penn Pain Medicine Center, Department of Anesthesiology and Critical Care, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Disclosure: Michael A. Ashburn, MD, MPH COI Summary (5 years looking backward): Dr. Ashburn has been the principle investigator for grants awarded to the University of Pennsylvania sponsored by Pfizer (2009), Cephalon (2009), GW Pharma (2012), AstraZeneca (2010), Endo Pharmaceuticals (2009), and GalaxoSmithKline (2009). Dr. Ashburn has been a co-investigator on grants awarded to the University of Pennsylvania to conduct clinical research sponsored by Medtronic, Inc. (2012). Over the last 5 years, Dr. Ashburn has served as a consultant to Becton Dickinson (2011), Cephalon (2011 and 2012), Cubist (2011), Maruishi (2011 and 2012), and Vantia (2010). Dr. Ashburn was a co-founder and shareholder of ZARS Pharma, which was purchased in 2011 by Nuvo Research. No other authors have any conflicts of interest/disclosures to report.
  • Practice Points:
    • Chronic pain is common and exerts a substantial social and economic burden on both the affected individual and society.
    • There are limited data to guide physician decision making. However, even when data exist, health care providers often do not provide care in accordance to best evidence. There is a high degree of variability in how health care is provided, and this variability contributes significantly to poor outcomes.
      • Standardization of the process of patient care improves patient outcomes even when there are limited data to guide decision making.
      • Integration of outcomes data collection into ongoing patient care is the cornerstone to efforts to improve patient outcomes.
      • Outcome measures should be carefully selected. Outcome measures should be valid (i.e., actually measure what they are intended to measure), easily understood, and as often as possible be similar to those measures used elsewhere to allow for comparison of outcomes among providers or programs.
      • Once outcome data collection is in place, programs can institute efforts to improve patient outcomes. These efforts can then be monitored via analysis of patient outcomes.
      • Quality is not a static goal, and therefore, continuous quality improvement programs are necessary.

Reprint requests to: Michael A. Ashburn, MD, MPH, Penn Pain Medicine Center, 1840 South Street, Philadelphia, PA 19146, USA. Tel: 215-893-7251; Fax: 215-893-7267; E-mail: Michael.Ashburn@uphs.upenn.edu.

Abstract

Objective

This manuscript reviews how patient-reported outcomes data can be used to guide efforts to improve patient outcomes.

Design

Review Manuscript.

Setting

The clinical management of chronic, non-cancer pain.

Subjects

Adult patients receiving treatment for chronic, non-cancer pain.

Results

While there have been great advances in the science of pain and various therapeutic medications and interventions, patient outcomes are variable. This manuscript reviews how outcomes data can be used to guide efforts to improve patient outcomes.

Conclusions

Patient outcomes can be improved with standardization of the process of patient care, as well as through other quality improvement efforts. The cornerstone to any effort to improve patient outcomes starts with the integration of valid outcomes data collection into ongoing patient care. Outcome measurement tools should provide information on several key domains, yet the process of data collection should not pose a significant burden on either the patient or health care team. Efforts to improve patient outcomes are ongoing, and should be a high priority for every health care team.

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