Trial Outcomes & Findings for Chronic Pain OneSheet Clinical Trial (NCT NCT04295135)

NCT ID: NCT04295135

Last Updated: 2024-05-24

Results Overview

Proportion of visits for patients with chronic pain for whom the PCP documented pain and/or function goals in the EHR, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

137 participants

Primary outcome timeframe

Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Results posted on

2024-05-24

Participant Flow

Primary care providers (PCP) were recruited after virtual staff meetings. PCP recruitment occurred in two phases: Phase 1(health system 1: Aug-Oct 2020; health system 2: Sept-Nov 2020) and Phase 2 (Sep-Dec 2021). Phase 2 recruited more PCPs to increase the sample size and allow new PCPs to participate. PCPs were randomly assigned to either a treatment or a control group (permanent assignment). We combined data from PCPs recruited in both phases for analysis.

Participant milestones

Participant milestones
Measure
OneSheet Access
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an electronic health record (EHR) decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Overall Study
STARTED
69
68
Overall Study
COMPLETED
59
63
Overall Study
NOT COMPLETED
10
5

Reasons for withdrawal

Reasons for withdrawal
Measure
OneSheet Access
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an electronic health record (EHR) decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Overall Study
Withdrawal by Subject
2
1
Overall Study
Subject left organization
8
4

Baseline Characteristics

Chronic Pain OneSheet Clinical Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
OneSheet Access
n=69 Participants
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=68 Participants
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Total
n=137 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
68 Participants
n=5 Participants
68 Participants
n=7 Participants
136 Participants
n=5 Participants
Age, Categorical
>=65 years
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Sex: Female, Male
Female
48 Participants
n=5 Participants
40 Participants
n=7 Participants
88 Participants
n=5 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
28 Participants
n=7 Participants
49 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=5 Participants
8 Participants
n=7 Participants
12 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
54 Participants
n=5 Participants
47 Participants
n=7 Participants
101 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
11 Participants
n=5 Participants
13 Participants
n=7 Participants
24 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
7 Participants
n=5 Participants
2 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
4 Participants
n=5 Participants
6 Participants
n=7 Participants
10 Participants
n=5 Participants
Race (NIH/OMB)
White
52 Participants
n=5 Participants
52 Participants
n=7 Participants
104 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants
n=5 Participants
8 Participants
n=7 Participants
13 Participants
n=5 Participants
Region of Enrollment
United States
69 participants
n=5 Participants
68 participants
n=7 Participants
137 participants
n=5 Participants
Years practicing medicine
10.2 years
STANDARD_DEVIATION 9.94 • n=5 Participants
9.7 years
STANDARD_DEVIATION 9.39 • n=7 Participants
10.0 years
STANDARD_DEVIATION 9.64 • n=5 Participants

PRIMARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live).

Proportion of visits for patients with chronic pain for whom the PCP documented pain and/or function goals in the EHR, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=252625 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=220179 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Pain and Function Goal-setting
Pre OneSheet Go-Live
0.0081 Proportion of patient visits
Standard Deviation 0.0898
0.0016 Proportion of patient visits
Standard Deviation 0.0404
Pain and Function Goal-setting
Post OneSheet Go-Live
0.0364 Proportion of patient visits
Standard Deviation 0.1873
0.0283 Proportion of patient visits
Standard Deviation 0.1659

PRIMARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live).

Proportion of visits for patients with chronic pain for whom the PCP documented the assessment of pain and/or function (e.g. Pain, Enjoyment, General Activity (PEG) scale in the EHR, as assessed by data extracted from the healthcare systems' clinical data warehouse. The PEG has a scale of 1-10, and is used to track an individual's changes over time. With effective therapy, an individual's score should decrease over time.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=252625 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=220179 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Pain, Enjoyment of Life, and General Activity (PEG) Documentation
Pre OneSheet Go-Live
0.0086 Proportion of patient visits
Standard Deviation 0.0923
0.0096 Proportion of patient visits
Standard Deviation 0.0973
Pain, Enjoyment of Life, and General Activity (PEG) Documentation
Post OneSheet Go-Live
0.0313 Proportion of patient visits
Standard Deviation 0.1741
0.0253 Proportion of patient visits
Standard Deviation 0.1572

PRIMARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain on LTOT starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live). The number of units (patient visits and participant counts) analyzed differs between the pre-OneSheet Go-Live and post-OneSheet Go-Live periods due to some PCPs only having qualifying visits in either the pre- or post- intervention period.

Proportion of visits for patients with chronic pain on long term opioid therapy (LTOT) for whom the PCP ordered a UDS, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=26942 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=23492 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Urine Drug Screening (UDS) Results Ordered
Pre OneSheet Go-Live
0.4175 Proportion of patient visits
Standard Deviation 0.4932
0.5486 Proportion of patient visits
Standard Deviation 0.4977
Urine Drug Screening (UDS) Results Ordered
Post OneSheet Go-Live
0.3746 Proportion of patient visits
Standard Deviation 0.4840
0.4705 Proportion of patient visits
Standard Deviation 0.4991

PRIMARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain on LTOT starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live). The number of units (patient visits and participant counts) analyzed differs between the pre-OneSheet Go-Live and post-OneSheet Go-Live periods due to some PCPs only having qualifying visits in either the pre- or post- intervention period.

Proportion of visits for patients with chronic pain on LTOT for whom the PCP accessed the PDMP report, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=26942 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=23492 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Prescription Drug Monitoring Program (PDMP) Reports Reviewed
Pre OneSheet Go-Live
0.7457 Proportion of patient visits
Standard Deviation 0.4355
0.7962 Proportion of patient visits
Standard Deviation 0.4028
Prescription Drug Monitoring Program (PDMP) Reports Reviewed
Post OneSheet Go-Live
0.8008 Proportion of patient visits
Standard Deviation 0.3994
0.8461 Proportion of patient visits
Standard Deviation 0.3609

SECONDARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain on LTOT starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live). The number of units (patient visits and participant counts) analyzed differs between the pre-OneSheet Go-Live and post-OneSheet Go-Live periods due to some PCPs only having qualifying visits in either the pre- or post- intervention period.

Proportion of visits for patients with chronic pain on LTOT for whom the PCP ordered naloxone, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=26942 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=23492 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Naloxone Prescriptions Ordered
Post OneSheet Go-Live
0.0054 Proportion of patient visits
Standard Deviation 0.0730
0.0090 Proportion of patient visits
Standard Deviation 0.0944
Naloxone Prescriptions Ordered
Pre OneSheet Go-Live
0.0012 Proportion of patient visits
Standard Deviation 0.0349
0.0004 Proportion of patient visits
Standard Deviation 0.0195

SECONDARY outcome

Timeframe: Assessed at baseline (looked back at previous 12 months) and 18-month treatment period

Population: PCPs enrolled during both recruitment phases and their visits with adult patients with chronic pain on LTOT starting at the baseline (looked back at previous 12 months; pre-OneSheet Go-Live) and 18-month treatment period (post-OneSheet Go-Live). The number of units (patient visits and participant counts) analyzed differs between the pre-OneSheet Go-Live and post-OneSheet Go-Live periods due to some PCPs only having qualifying visits in either the pre- or post- intervention period.

Proportion of visits for patients with chronic pain on LTOT for whom the PCP ordered a medication for opioid use disorder, as assessed by data extracted from the healthcare systems' clinical data warehouse.

Outcome measures

Outcome measures
Measure
OneSheet Access
n=26942 Patient visits
PCPs who receive access to, and training in the Chronic Pain OneSheet, and use it while caring for patients with chronic pain. Chronic Pain OneSheet: The Chronic Pain OneSheet (OneSheet) is an EHR decision support tool that uses behavioral economics to increase adoption of chronic pain guideline recommendations. OneSheet works by aggregating and structuring information that is already collected, that PCPs often need while caring for patients with chronic pain conditions. By aggregating and structuring this information in a more convenient manner, the goal of OneSheet is to make the information that is important in clinical decision making more readily available, and to reduce the amount of time that PCPs need to spend locating this information.
Normal Practice
n=23492 Patient visits
PCPs who do not receive access to, or training in the Chronic Pain OneSheet, and care for patients with chronic pain as they would normally.
Medications for Opioid Use Disorder Prescription Ordered
Pre OneSheet Go-Live
0.0119 Proportion of patient visits
Standard Deviation 0.1083
0.0092 Proportion of patient visits
Standard Deviation 0.0957
Medications for Opioid Use Disorder Prescription Ordered
Post OneSheet Go-Live
0.0383 Proportion of patient visits
Standard Deviation 0.1919
0.0373 Proportion of patient visits
Standard Deviation 0.1895

Adverse Events

OneSheet Access

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Normal Practice

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Christopher A. Harle

Indiana University

Phone: 317 278 3245

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place