Pain Addiction Progress 2009-6
From Clinicaltools.com
Contents |
Project Guide
SBIR Phase II Contract #HHSN271200900003C
ADB Contract No. N44-DA-9-2213
Title: Web Based Training for Pain Management Providers
PI: T. Bradley Tanner, MD
Monthly Progress Report #3 of 24
Reporting Period: 6/1/09 – 6/30/09
Project Period: 4/1/09 – 3/31/11
Pain and Addiction Project Framework
Overview
This has been another productive month with substantial progress in development of the user interface and functionality for the website PainandAddictionTreatment.com as well as its content. Expert consultants began reviewing some of the content this month and we are encouraged by their feedback.
Progress During June 2009
Objective 1
Develop Skills Training Content
Courses: We completed early drafts of the educational content for three of the four core courses (Initial Assessment, Initial Prescribing, Ongoing Management). Detailed information provided in Key Info Guides was condensed and summarized in the courses. We also started writing interactive quiz questions for these courses. We began writing the background content for the final two courses, which will be standardized patient courses organized by pain condition and type of substance use problem.
Resources: This month we focused on developing the taxonomy system that will be used to enable a faceted (refinable) search of the Resources. a list of "tags" and categories to define our growing resources. Tags are labels that identify specific elements within a resource. They help users to find information by making it possible to search for resources based on keywords. In contrast, "categories" are general umbrella classifications that encompass the broad idea of the resources that fall under them. Most resources should have only one category that represents the theme of the resource. Resources should have multiple tags since they are more specific than categories. See Appendix A for a list of the tags and categories we will use.
We also collected additional resources related to screening and assessment instruments as well as miscellaneous other topics related to pain and addiction.
"Key Info" Guides: We completed another guide (Informed Consent and Patient Treatment Agreements) and worked on the remaining four guides (Evidence on Long Term Opioid Use, Opioid Prescribing guidelines, Assessment Tools, and Prescription Drug Monitoring).
Objective 2
Build Supporting Functionality
Homepage
- Further design elements and functionality were added to the homepage to give the section better definition. Home page elements were also re-organized and simplified.Our goal was to develop a version that can be tested in usability testing next month.
- A new banner was added to the site, as well as a site logo and matching icon.
- A footer was added to the homepage, including NIDA funding information.
General Technologies
- A CTI core theme was created to allow core features to be installed uniformly to all of CTI's sites. A "pain and addiction" sub-theme was created from this to allow more individualized features to be added to the PainAndAddictionTreatment.com site. The site was transferred from the original theme to this new sub-theme. Thus, this website will automatically benefit from improvements that are applied to the core features of all of our websites.
- In response to several spam attempts, a completely automated public turing test to tell computers and humans apart, or "CAPTCHA," was configured to prevent spamming of the message boards on the site. The CAPTCHA automatically generates questions only a human can answer with each attempted registration.
- A flexible CSS page layout was set up, which allows the widths of the middle content area to expand automatically in the absence of right and/or left sidebars. The flexibility of using from one to three sections will fit better with the different types of content available on the site. For example, some pages, but not all, include a "Did You Know?" section where tangentially related but important information can be revealed.
- CSS design elements were added to the Key Info Guides and Course pages.
- The top level of navigation for Course and Key Info Guides were converted from "nice" menus to "book" navigation matching the lower level of navigation already in place. This allows us to use as few extra modules as possible and gives greater flexibility for css styling of the navigation.
- A "Test Your Knowledge" content type was created, to serve as mini-quizzes with four questions and answers, and explanations for each answer choice. The answers are displayed as "clicktips" that reveal each corresponding explanation.
- The Test Your Knowledge, Course Content, and Course Page content types were styled using CSS to improve the margins, padding, colors, and overall appearance and layout of the fields.
Objective 3
Evaluate Curriculum Content
- Expert consultants began reviewing content this month. We are using an iterative review process, sending guides and courses initially to a single consultant with the most expertise in that area. After each guide or course is reviewed by a single consultant we will have all consultants review all guides and courses.
We sent the "Urinary Drug Testing" guide to consultant Peggy Compton and the "Government Regulations for Prescribing Controlled Substances" guide to Howard Heit. We then revised each guide according to their feedback. Following expert review, we used the detailed information provided in these guides to create succinct summaries within the CME courses.
Objective 4
Evaluate Interface Design (Usability)
We began identifying issues to be tested in the usability test scheduled for July 2009. For example, we will test two different functionalities for interactive quiz questions.
Objective 5
Obtain OMB clearance
No activity this month.
Objective 6
Conduct Summative Evaluation
Scheduled for year 2.
Objective 7
Disseminate Results
No action this month.
Work to be Performed in the Next Reporting Period
Objective 1
Develop Skills Training Content
Courses: We will finalize the first drafts of the basic didactic educational content for the first three of the core courses (Initial Assessment, Initial Prescribing, and Ongoing Monitoring) and start creating mini-case scenarios to illustrate each step. We will also complete development of quiz questions and pre/post-tests. We will send courses to expert consultants for review as they are completed.
Resources: We will continue to catalogue resources by applying "tags" to each resource in the data base. We will create a user guide to finding the right assessment using a faceted search of the Resources.
Key Info Guides: We will complete the first drafts of the remaining guides and send them to expert consultants for review as they are completed.
Objective 2
Build Supporting Functionality
General
- Develop a simple guide for physicians detailing how to use the resource search tool to find the best screening or assessment tool for a particular purpose.
- Convert the course pages from book page format to the "course content" type format
- The Reference and Resources sections will be converted to expandable clicktips, allowing the reader to expand them or keep them hidden
- A "Recent News" section will be added to showcase changes in FDA regulations or recommendations from professional organizations, such as opioid prescribing guidelines, as well as new additions and developments to the site.
Resources
- Develop the faceted search feature of the Resource Center so searches on a topic can be narrowed down by clicking tags related to the field of interest
- Develop a search tool for assessment tools which will rely on a system of tagging
- Improve the faceted search by developing an exhaustive list of tags and categories and incorporating them into the resource center.
Objective 3
Evaluate Curriculum Content
Send completed How to Guides and core courses to consultants for review as they are completed and revise according to feedback.
Objective 4
Evaluate Interface Design (Usability)
Develop assessment tool and recruit 9 participants for usability test scheduled for late July 2009.
Objective 5
Obtain OMB clearance
Develop the summative assessment to be included in the OMB clearance application.
Objective 6
Conduct Summative Evaluation
Develop the summative evaluation assessment tool for the summative evaluation that is scheduled for year 2 as described above. This assessment will be included in the OMB application.
Objective 7
Disseminate Results No activity
Contact
Please feel free to contact me if you have any questions or concerns. I can be reached at (919) 960-8118 or tanner at clinicaltools dot com.
T. Bradley Tanner, MD (President, Clinical Tools, Inc.)
Appendix A: Resource Categories and Tags
Categories:
- Overview of Pain
- Opioid Use in Pain Treatment
- Pain and Addiction
- Addiction in Pain Patients
- Pain in Addiction Patients
- Addiction/Substance Abuse (general)
- Screening/Brief Assessment
- Patient Education
- Guidelines
- Organizations (Pain or Addiction)
- Diversion
- Back Pain (If we do this one, we'd have to add acute, arthritis, headache, etc - too many- keep as a tag? create a category Pain Type with subtypes?)
- Physician Locators
- Cancer Pain
- Complementary and Alternative Therapies
- Continuing Education (delete this and combine with Online Course type?
- Mental Health Factors
Tags: aberrant behaviors, abuse, acute pain, addiction, adherence monitoring, adolescents, adverse reactions, allodynia, analgesics, assessment, back pain, behavioral therapy, benzodiazepines, breakthrough pain, brief intervention, buprenorphine, cancer, chemical coping, codeine, comanagement, comorbidities, complications, confidentiality, consent, continuing care, dependence, detoxification, diagnosis, discontinuation, diversion, dosing, drug seeking, elderly patients, faq,fentanyl, fibromyalgia, forum, headache, heroin, hyperalgesia, intermittent pain, intervention, legal matters, license, locator, maintenance, mental health problems, methadone, migraine, misuse, morphine, naloxone, neuropathy, nociceptive, non-pharmacologic, older adults, opiophobiaosteo arthritis, overdose, oxycodone, pain, paroxysmal pain, patient agreements, patient selection, perceptions, pharmacology, pharmacotherapy, pharmacy, pill counts, polysubstance abuse, precautions, pregnant, propoxyphene, pseudo-addiction, psychiatric, psychosocial, questionnaire, recordkeeping, referral, regulations, rehabilitation, relapse, risk factors, rotation, screening, somatic pain, Spanish language, special populations, stratification of risk, symptoms, tapering, titration, tolerance, tramadol, triage, urine testing, visceral pain, withdrawal
Other Progress Reports
Phase I Pain Addiction Progress • April 2009 • May 2009 • June 2009 • July 2009 • August 2009 • September 2009 • October 2009 • November 2009 • December 2009 • January 2010 • February 2010 • March 20010
