Randomized clinical trial of computerized PAINRelieveIt® for patients with sickle cell disease: PAINReportIt® and PAINUCope®.
Brenda W Dyal, Miriam O Ezenwa, Yingwei Yao and 5 others
PMID 31451364WHAT IT FOUND
In adults with sickle cell disease, a tablet-based tailored pain education did not reduce barriers, pain, or medication adherence compared with usual care.
Few participants used the education long enough to complete it.
Key findings
01After controlling for pretest scores, posttest barriers, pain index, and analgesic adherence were not significantly different between the education and usual-care groups.
02Less than 30% of intervention-group participants opened and viewed the tailored education for its full length.
03The intervention group's analgesic adherence change from pretest to posttest was statistically significant, but usual care was not, and posttest between-group differences were not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
One outpatient sickle cell clinic in the Midwest U.S. was studied, so results may not generalize to other settings. Participants did not fully engage with the education: intervention delivery was 55% to 81%, but less than 30% viewed content for the full length. The complete education required 18.55 minutes, more time than patients engaged in the clinic setting. Follow-up occurred at the next clinic visit, not always at 3 months; of 184 participants who completed the posttest, 116 did so within 6 months, 46 between 6 months and 1 year, and 22 after more than 1 year. Analgesic adherence was based on patient report for the previous 24 hours. Groups differed on barriers at pretest, with the control group fairing worse, although analysis controlled for pretest values.
Declared interests
The article is tagged as supported by NIH extramural research. No conflict-of-interest declaration is provided.
The easy way to misread this
Do not read the within-group change in analgesic adherence as proof that the tablet education works. The between-group difference at follow-up was not significant, and most participants did not engage with the education long enough to complete it.