- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02568618
Patient and Provider Confidence and Satisfaction With the Clinical Use of CYP Genetic Variability (Genomics)
Patient and Provider Confidence and Satisfaction With the Clinical Use of CYP Genetic Variability Analysis to Guide Analgesic Treatment: A Randomized, Controlled Pilot Study Using the Pain Medication and Mental Health DNA InsightTM Test.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a prospective, randomized, controlled, interventional pilot study analyzing both providers' and patients' perceptions and responses to the DNA Insight test. Twelve military health system primary care providers and 4 of each provider's patients will be enrolled in the study. (12 providers and 48 patients total) Each provider's patients will be randomized into delayed treatment (Group A) or immediate treatment (Group B) at a 1:1 ratio. All patients receive the Pain Medication and Mental Health DNA InsightTM test (intervention). Results for patients in Group A will be given to the provider with a 3 month delay. Those in the 3 month delay will serve as a comparison group for the period prior to receiving intervention. Results for patients in Group B will be given to the provider without delay, 2-3 weeks after saliva sample collection. The provider will use the results of the Pain Medication and Mental Health DNA InsightTM test to evaluate whether changes of medications are indicated based on the individual patient's genetic profile. A measure of the provider's certainty, confidence, satisfaction, perception of care and global impression of change will be assessed at baseline, prior to obtaining the test results, and after obtaining the test results, as outlined in the data collection section. Patients' pain related self-reported outcomes, certainty, confidence and satisfaction will be assessed at baseline, prior to obtaining the DNA InsightTM test results, and after receipt and implementation of the test results, as described in the data collection section of the protocol.
At the baseline visit (Visit 0) each enrolled patient will provide a saliva sample for the Pain Medication DNA InsightTM test that identifies genetic variation in CYP metabolism. The providers and patients will be recruited from any of the Womack Army Medical Center's Primary Care Medical Homes and family practice clinics.
Study Type
Enrollment (Actual)
Phase
- Early Phase 1
Contacts and Locations
Study Locations
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North Carolina
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Fort Bragg, North Carolina, United States, 28310
- Womack Army Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Military healthcare system beneficiary enrolled in the Womack Army Medical Center Health Care System
- Age 18 or older
- Patient of the enrolled provider for at least 3 months.
- Persisting pain for at least 3 months, with average daily pain score of 4 or higher that is not expected to improve without directed therapy.
- No history of chronic liver or kidney disease
Exclusion Criteria:
- Known pregnancy or breast feeding
- Planned deployment, permanent change of station, or military separation within upcoming 6 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Immediate
Subjects will receive the results of the Pain Medication DNA Insight (TM) test at Visit 1.
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The DNA insight test uses saliva to test the metabolism of certain pain and mental health medications to determine if the subject is a poor metabolizer, intermediate metabolizer or ultrarapid metabolizer.
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Other: Delayed
Subjects will receive the results of the Pain Medication DNA Insight (TM) test at Visit 4. After 3 months of standard treatment.
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The DNA insight test uses saliva to test the metabolism of certain pain and mental health medications to determine if the subject is a poor metabolizer, intermediate metabolizer or ultrarapid metabolizer.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Provider Satisfaction, Certainty and Confidence survey
Time Frame: 6 months
|
Examine trends in provider decisions in prescribing analgesics and modifying analgesic treatment plans and provider outcomes for satisfaction, certainty and confidence in dosing of analgesics with and without access to Pain Medication and Mental Health DNA Insight ™ genetic testing results.
A certainty, confidence, satisfaction survey, provider perception of care and provider global impression of change surveys will be administered to the provider after each visit from each study subject.
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6 months
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Provider perception of care survey
Time Frame: 6 months
|
Examine trends in provider decisions in prescribing analgesics and modifying analgesic treatment plans and provider outcomes in perception of care
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6 months
|
Provider global impression of change survey
Time Frame: 6 months
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Examine trends in provider decisions in prescribing analgesics and modifying analgesic treatment plans and provider outcomes for global impression of change
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6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient certainty, confidence and satisfaction survey
Time Frame: 6 months
|
Examine trends in patients' satisfaction, certainty and confidence in dosing of analgesics between patient groups whose providers had access to Pain Medication and Mental Health DNA Insight ™ genetic testing results and those whose providers did not have access to the genetic information.
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6 months
|
Patient perception of care survey
Time Frame: 6 months
|
Examine trends in patient perception of care in dosing of analgesics between patient groups whose providers had access to Pain Medication and Mental Health DNA Insight ™ genetic testing results and those whose providers did not have access to the genetic information.
|
6 months
|
Patient global impression of change survey
Time Frame: 6 months
|
Examine trends in patients' global impression of change in dosing of analgesics between patient groups whose providers had access to Pain Medication and Mental Health DNA Insight ™ genetic testing results and those whose providers did not have access to the genetic information.
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6 months
|
Patient Outcomes pain as assessed by the DVPRS
Time Frame: 6 months
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Compare patient-reported pain between patient groups whose providers had early access to Pain Medication and Mental Health DNA Insight ™ genetic testing results to those who had delayed access in the control period and subsequently following later access to the results.
Subjects will be ask to complete the DVPRS pain scale, a visual analog scale.
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6 months
|
Patient Outcomes pain as assessed by BPI perception of pain relief item
Time Frame: 6 months
|
Compare patient-reported pain between patient groups whose providers had early access to Pain Medication and Mental Health DNA Insight ™ genetic testing results to those who had delayed access in the control period and subsequently following later access to the results.
Subjects will be ask to complete the BPI perception of pain relief item prior to each provider visit.
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6 months
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Patient Outcomes pain as assessed by the PROMIS Pain short form
Time Frame: 6 months
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Compare patient-reported pain between patient groups whose providers had early access to Pain Medication and Mental Health DNA Insight ™ genetic testing results to those who had delayed access in the control period and subsequently following later access to the results.
Subjects will be ask to complete the PROMIS pain interference short forms prior to each provider visit.
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6 months
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Patient Outcomes of demographics
Time Frame: 6 months
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Compare patient-reported demographics for equality in sampling
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6 months
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Patient Outcomes of depression as assessed by the PROMIS depression short form
Time Frame: 6 months
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Compare patient-reported depression between patient groups whose providers had early access to Pain Medication and Mental Health DNA Insight ™ genetic testing results to those who had delayed access in the control period and subsequently following later access to the results.
Subjects will be ask to complete the PROMIS depression short form prior to each provider visit.
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6 months
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Patient Outcomes of anxiety as assessed by the PROMIS anxiety short form
Time Frame: 6 months
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Compare patient-reported anxiety between patient groups whose providers had early access to Pain Medication and Mental Health DNA Insight ™ genetic testing results to those who had delayed access in the control period and subsequently following later access to the results.
Subjects will be ask to complete the PROMIS anxiety short form prior to each provider visit.
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6 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Michael Bartoszek, MD, United States Department of Defense
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 409729
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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