# The Use of a Digital Application for Reporting Pain and Pain Management in Home Hospice

> **NIH NIH R21** · RUSH UNIVERSITY MEDICAL CENTER · 2021 · $196,250

## Abstract

Project Summary/Abstract
High pain intensity is a common symptom experienced by patients with serious advanced illness. However,
pain management for patients in home hospice is less than optimal. Impediments to improving pain intensity
are poor adherence to pain management regimen due in part to caregiver lack of knowledge (a barrier to
reporting pain and using analgesics) and lack of self-efficacy (confidence) in administering analgesics. Digital
applications may facilitate pain management by: (1) delivering education to increase knowledge and self-
efficacy, (2) expediting pain reporting to nurses, and (3) improving adherence to pain management. e-
PainSupport is a self-administered, digital pain management application developed in collaboration with
hospice nurses and caregivers. It is directly linked to a patient’s medical record and enhanced by an evidence-
based educational module. It has three elements: (a) Educational Module, (b) Patient Pain Record, and (c)
Pain Summary for Nurses. The purpose of this study is to test the effects of e-PainSupport on home hospice
patient pain intensity when used by patients, caregivers and nurses. Specific aims are: Aim 1. Compare the
effects of e-PainSupport to a standard care condition, controlling for covariates (role [patient or caregiver], age,
sex, ethnicity and education of the patient and the caregiver and patient’s diagnosis) on hospice patient
minimally important clinical improvement in pain intensity (at least 10% improvement on the pain intensity
scale)11 (primary outcome) and significant improvement in the continuous score of the pain intensity scale
(secondary outcome). Aim 2. Examine the mediating effects of hospice patient and caregiver knowledge of
pain management, self-efficacy, and adherence to pain management on change in patient pain intensity over a
two-week period, controlling for covariates (role [patient or caregiver], age, sex, ethnicity, education of the
patient and the caregiver, and patient’s diagnosis) and treatment condition. Aim 3. Identify hospice nurses’
perceptions of their actions based on using e-PainSupport, including: (a) facilitators and barriers to integrating
the app into the agency workflow and (b) benefits of e-PainSupport for pain management of patients in home
hospice. Participants (132 triads of patient, caregiver, and the hospice nurse assigned to the patient) will be
recruited from one large Midwest hospice agency. Patient and caregiver outcomes will be assessed at baseline
and 2 weeks post baseline. Data will be analyzed with multi-level modeling. Post-intervention semi-structured
interviews will be conducted with nurses who provided care to patients in the e-PainSupport condition.
Qualitative content analysis will be used to identify themes related to perceived practice changes after using e-
PainSupport. e-PainSupport has potential as a useful tool to advance home hospice care by enhancing the
quality of caregiver pain management, facilitating nurse-pati...

## Key facts

- **NIH application ID:** 10236535
- **Project number:** 5R21NR018952-02
- **Recipient organization:** RUSH UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Masako Mayahara
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $196,250
- **Award type:** 5
- **Project period:** 2020-08-11 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10236535

## Citation

> US National Institutes of Health, RePORTER application 10236535, The Use of a Digital Application for Reporting Pain and Pain Management in Home Hospice (5R21NR018952-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10236535. Licensed CC0.

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