Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering

ObjectivesTapering prescription opioid pain medication through evidence-based guidelines can help in combating the opioid epidemic. Integrating clinical decision support (CDS) into the clinical workflow of tapering can help in translating guidelines to formulate and implement a tapering plan that ma...

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Main Authors: Sadaf Kazi, Robin Littlejohn, Kelly M. Smith, Deanna-Nicole Busog, Joseph Blumenthal, Shrey Mathur, Zach McGill, Doug DeBold, Aaron Zachary Hettinger, Kristen E. Miller
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1474699/full
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author Sadaf Kazi
Sadaf Kazi
Robin Littlejohn
Kelly M. Smith
Kelly M. Smith
Deanna-Nicole Busog
Joseph Blumenthal
Shrey Mathur
Zach McGill
Doug DeBold
Aaron Zachary Hettinger
Aaron Zachary Hettinger
Kristen E. Miller
Kristen E. Miller
Kristen E. Miller
author_facet Sadaf Kazi
Sadaf Kazi
Robin Littlejohn
Kelly M. Smith
Kelly M. Smith
Deanna-Nicole Busog
Joseph Blumenthal
Shrey Mathur
Zach McGill
Doug DeBold
Aaron Zachary Hettinger
Aaron Zachary Hettinger
Kristen E. Miller
Kristen E. Miller
Kristen E. Miller
author_sort Sadaf Kazi
collection DOAJ
description ObjectivesTapering prescription opioid pain medication through evidence-based guidelines can help in combating the opioid epidemic. Integrating clinical decision support (CDS) into the clinical workflow of tapering can help in translating guidelines to formulate and implement a tapering plan that manages pain symptoms while minimizing withdrawal, and optimally engages with the patient. The purpose of our project was to develop patient- and clinician-facing CDS in the area of chronic pain management in one integrated application (app) called Tapering And Patient Reporting outcomes for Chronic Pain Management (TAPR-CPM) App.MethodsWe leveraged human factors methodologies and a user-centered design (UCD) approach through guideline review, stakeholder interviews, ethnographic workflow analysis, process mapping, design workshops, and usability testing. Participants included patients with chronic noncancer pain, their family members, pain management physicians, primary care physicians, and health IT developers who focus on patient- and provider-facing technologies.ResultsBased on interview findings and workflow analysis, the provider-facing app had five sections: Patient Context, Taper Settings, Create Taper Plan, Withdrawal and Non-opioid Pain Plan, and Summary Dashboard. The patient-facing app had three sections: Maintaining a Pain Journal, Sharing Pain Scores with Provider, and Connecting to Resources about Opioid Tapering.ConclusionsThis project leveraged a multi-method approach based in human factors and UCD to develop the TAPR-CPM app. Engaging with a diverse set of stakeholders including patients, caregivers, primary care providers, pain specialists, and health information technology developers was critical to develop a user-friendly experience with accessible technology to support patient engagement and provider decision-making.
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spelling doaj-art-125f0252f02a4cbf9b3c7c51ecf576942025-08-20T02:12:06ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-04-01510.3389/frhs.2025.14746991474699Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineeringSadaf Kazi0Sadaf Kazi1Robin Littlejohn2Kelly M. Smith3Kelly M. Smith4Deanna-Nicole Busog5Joseph Blumenthal6Shrey Mathur7Zach McGill8Doug DeBold9Aaron Zachary Hettinger10Aaron Zachary Hettinger11Kristen E. Miller12Kristen E. Miller13Kristen E. Miller14National Center for Human Factors in Healthcare, MedStar Health Research Institute, Columbia, MD, United StatesSchool of Medicine, Georgetown University, Washington, DC, United StatesNational Center for Human Factors in Healthcare, MedStar Health Research Institute, Columbia, MD, United StatesInstitute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaDepartment of Patient-Oriented Research, Michael Garron Hospital, Toronto, ON, CanadaNational Center for Human Factors in Healthcare, MedStar Health Research Institute, Columbia, MD, United StatesCenter for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Columbia, MD, United StatesCenter for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Columbia, MD, United StatesVessel Partners, Minneapolis, MN, United StatesVessel Partners, Minneapolis, MN, United StatesSchool of Medicine, Georgetown University, Washington, DC, United StatesCenter for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Columbia, MD, United StatesNational Center for Human Factors in Healthcare, MedStar Health Research Institute, Columbia, MD, United StatesSchool of Medicine, Georgetown University, Washington, DC, United StatesCenter for Diagnostic Systems Safety, MedStar Health Institute for Quality and Safety, Columbia, MD, United StatesObjectivesTapering prescription opioid pain medication through evidence-based guidelines can help in combating the opioid epidemic. Integrating clinical decision support (CDS) into the clinical workflow of tapering can help in translating guidelines to formulate and implement a tapering plan that manages pain symptoms while minimizing withdrawal, and optimally engages with the patient. The purpose of our project was to develop patient- and clinician-facing CDS in the area of chronic pain management in one integrated application (app) called Tapering And Patient Reporting outcomes for Chronic Pain Management (TAPR-CPM) App.MethodsWe leveraged human factors methodologies and a user-centered design (UCD) approach through guideline review, stakeholder interviews, ethnographic workflow analysis, process mapping, design workshops, and usability testing. Participants included patients with chronic noncancer pain, their family members, pain management physicians, primary care physicians, and health IT developers who focus on patient- and provider-facing technologies.ResultsBased on interview findings and workflow analysis, the provider-facing app had five sections: Patient Context, Taper Settings, Create Taper Plan, Withdrawal and Non-opioid Pain Plan, and Summary Dashboard. The patient-facing app had three sections: Maintaining a Pain Journal, Sharing Pain Scores with Provider, and Connecting to Resources about Opioid Tapering.ConclusionsThis project leveraged a multi-method approach based in human factors and UCD to develop the TAPR-CPM app. Engaging with a diverse set of stakeholders including patients, caregivers, primary care providers, pain specialists, and health information technology developers was critical to develop a user-friendly experience with accessible technology to support patient engagement and provider decision-making.https://www.frontiersin.org/articles/10.3389/frhs.2025.1474699/fullhuman factors engineering (HFE)chronic painopioid taperinguser-center designpatient-reported outcomes
spellingShingle Sadaf Kazi
Sadaf Kazi
Robin Littlejohn
Kelly M. Smith
Kelly M. Smith
Deanna-Nicole Busog
Joseph Blumenthal
Shrey Mathur
Zach McGill
Doug DeBold
Aaron Zachary Hettinger
Aaron Zachary Hettinger
Kristen E. Miller
Kristen E. Miller
Kristen E. Miller
Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
Frontiers in Health Services
human factors engineering (HFE)
chronic pain
opioid tapering
user-center design
patient-reported outcomes
title Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
title_full Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
title_fullStr Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
title_full_unstemmed Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
title_short Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering
title_sort extending care beyond the clinic integrating patient reported outcomes in chronic pain management through human factors engineering
topic human factors engineering (HFE)
chronic pain
opioid tapering
user-center design
patient-reported outcomes
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1474699/full
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