Disability Claimants and the Implementation of a Web-Based Pain Assessment/Pain Management Program

How important is a pain management program in the clinical setting? Recently, Inflexxion partnered with Aetna Disability to answer this question, exploring the impact of using a clinical assessment system and pain management resources with disability claimants as part of a pain management program. Two of Inflexxion’s tools were implemented, PainCAS Clinical Assessment System, a pain and opioid risk assessment, and painACTION, a patient-focused web-based educational resource. These tools are validated for use with chronic pain patients treated in medical offices and hospitals, and have proven effectiveness in pain management.

The Patients

Patients in the study were disability claimants on leave from their jobs at UPS with musculoskeletal diagnoses. The average age of the patients was 44 years old. Clinicians offered all patients the opportunity to utilize Inflexxion’s PainCAS and painACTION tools.

The team identified the inherent mistrust for insurance companies as an early barrier to treatment of the disability patients. Clinicians involved in the program were short-term disability plan nurses employed by Aetna. Researchers found that, in comparison with patients in earlier studies in which primary care physicians or other healthcare practitioners administered pain management programs, patients were more hesitant to trust clinicians employed by an insurance company. Due to this mistrust, and factors that varied by individual, 34% of patients refused to participate outright.

The Method

Ultimately, 58 patients agreed to participate and 22 participated fully – meaning they took one or more PainCAS assessment. The 36 patients who agreed to participate, but did not complete the program,  and 2015 UPS disability claimants similar in diagnosis were compared to the 22 who agreed to  participate and did fully complete the program.

Those who fully participated met with Aetna short-term disability plan nurse clinicians at least once over a seven-month period to complete a PainCAS assessment and discuss their profile. In more detail, the general plan for those who fully participated was as follows:

1. The patient completed the PainCAS clinical assessment.
2. The nurse and patient discussed PainCAS profiles after the completion of the assessment.
3. The nurse pointed the patient to web-based painACTION resources that expanded from the patient’s personal PainCAS profile.
4. The nurses forwarded the patient’s profile to their primary care practitioner (with patient consent).
5. Nurses then offered for the participant to retake the PainCAS assessment every 2-3 weeks for the duration of their disability leave.

The Outcome

The results from the study demonstrate the usefulness of PainCAS and painACTION with disability patients and in new clinical settings. Patients who completed the PainCAS had more “engaged and clinically relevant” discussions with their clinicians. Furthermore, those who fully participated required, on average, 28 fewer disability days than their colleagues who did not fully participate.

Of those who fully participated in the program, 72.7% had returned to work one month after the completion of the  program compared to 36.1% in the group that did not fully participate. Similarly, 22.9% of those who did not fully participate in the program still had an active claim one month after the program, only 4.5% of those who fully participated still had an active claim open.

Ultimately, the study verified the usefulness of a clinical assessment and web-based resources as significant components of a short-term disability treatment plan.