Effectiveness of a Computerized Tool (PAINRelieveIt) to Help Manage Pain Related to Sickle Cell Disease

SCD is an inherited blood disorder that mainly affects people of African, Mediterranean, or Latin descent. Symptoms include anemia, infections, organ damage, and painful sickle cell crises. Adults with SCD who experience frequent painful crises are more likely to die sooner than are adults with SCD who have fewer painful crises. Experts suggest that SCD pain be treated in the same way that cancer pain is treated because both types of pain are sustained and severe. However, unlike the research directed towards cancer pain, research focused on the characteristics of SCD pain has been limited. Although medications are available to treat SCD pain, the SCD pain management process is complex and often requires more time than what is available during the typical medical appointment. Recent advances in computer technologies may provide an opportunity to improve the effectiveness of SCD pain management by combining online patient education with decision-making support tools for doctors. This study will evaluate three touch screen computerized tools that are known collectively as PAINRelieveIt. The three tools include the following:

• PAINReportIt-a pain assessment data collection tool
• PAINUCope-a multimedia patient education program tailored to the participant's SCD pain management misconceptions
• PAINConsultN-a decision support tool for doctors that will provide algorithm-based pain medication therapies tailored to each participant's pain level

This two-part study will evaluate the effectiveness of PAINReportIt and PAINUCope, alone and in combination with PAINConsultN, at improving participants' SCD pain by educating participants about their role in pain management and by providing decision-making support to doctors.

This study will enroll patients who are receiving care at the University of Illinois at Chicago Sickle Cell Clinic. The patients will be randomly assigned to either the experimental group or the control group. It comprises two phases. In Phase 1, the patients in the experimental group will have access to PAINReportIt and PAINUCope, which the control will have access to PAINReportIt and a selection of games. At baseline and Month 3, participants will complete questionnaires on misconceptions about pain, medication adherence, and pain intensity. The same participants from Phase 1 of the study will be enrolled into Phase 2 of the study with the same group assignment, which will last 2 years. In Phase 2, the experimental group participants will be assigned to receive care from doctors who have access to PAINConsultN while the control group will be assigned to usual care. All participants will have access to PAINReportIt and PAINUCope in Phase 2. At baseline and Year 2, participants will complete questionnaires on pain episodes. Information will also be collected from doctors, including pain documentation, appropriateness of prescribed pain medications, and the number of emergency department visits by and hospitalizations of participants experiencing painful SCD crises.

Inclusion criteria

• Diagnosed with SCD
• Scheduled for continuing care at the University of Illinois at Chicago Sickle Cell Clinic
• Experienced a moderate to severe level of pain (at least 3 on 0 to 10 scale) related to the SCD within the 12 months prior to study entry
• Had a emergency department visit or hospitalization within the 2 years prior to study entry
• Speaks and reads English

Exclusion criteria

• Legally blind
• Physically unable to complete study questionnaire