©2024 Stanford Medicine
Effective Screening for Pain Study
Not Recruiting
Trial ID: NCT01816763
Purpose
In light of the importance of pain and widespread interest in patient-centeredness, the
Department of Veterans Affairs (VA) has been emphasizing and successfully making pain and its
management a routine feature of the health record and a focus of care. Awareness of pain and
efforts to improve pain management rest on the VA's '5th Vital Sign' - a policy and practice
of nursing staff routinely screening for 'pain now' at every health encounter using a 0-10
Numeric Rating Scale (NRS).
The team's previous research on VA's '5th Vital Sign' informs the specific design of this
Effective Screening for Pain (ESP) study as well as the proposed research products.
Alternatives to the current pain screening approach may improve the sensitivity and
specificity of screening for chronic pain. These alternatives include the nurse administered
NRS with a one week look back period and a three item scale (PEG) incorporating intensity and
emotional and physical interference. The PEG is very similar to the gold standard Brief Pain
Inventory (BPI) from which it is derived, in its sensitivity, specificity, and sensitivity to
change in detecting clinically important, functionally impairing pain.
The investigators plan to evaluate alternatives to the VA's current '5th Vital Sign' for pain
screening, focusing on simple, feasible measures that can be used cross-sectionally for pain
screening. In the setting of a primary care clinic, the investigators plan to
cross-sectionally evaluate three arms - a tablet based DVPRS, a tablet computer-based NRS one
week, and a tablet computer-based PEG. All arms will be compared with the nurse administered
NRS.
Official Title
Effective Screening for Pain Study
Stanford Investigator(s)
Eligibility
Inclusion Criteria:
- All Veterans are eligible to participate in the clinical trial when presenting for
routine care in the primary care clinic at all sites (VA at Palo Alto, Minneapolis,
and Portland).
- All are eligible who do not opt out of participation.
- All participants in the baseline tablet intervention will also be eligible for a one
week follow up telephone interview - unless they are unable to complete a phone
interview (see exclusions).
- For the qualitative Veteran component, all Veterans who can hear and respond in an
interview are eligible.
- Providers/staff must be clinic and facility staff including administrative clerks,
regular part time or full time employees in primary care who routinely participate in
the care of Veterans who have painful conditions.
Exclusion Criteria:
- Veterans who meet either of the following exclusion criteria that may interfere with
outcome assessment will be ineligible for the follow up telephone interview:
- a) no working telephone (home, office, or mobile)
- b) hearing impaired and unable to complete a phone survey
Intervention(s):
behavioral: PEG
behavioral: PEG
behavioral: NRS pain one week
behavioral: DVPRS
Not Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
Karl A Lorenz, MD MSHS
650-493-5000 Ext. 22173