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Characterizing the Complexity of Advanced Cancer Pain in the Home Context by Leveraging Smart Health Technology

Award Number: R01NR019639
ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/01/2021
PERIOD OF PERFORMANCE END DATE: 11/30/2026

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Characterizing the Complexity of Advanced Cancer Pain in the Home Context by Leveraging Smart Health Technology - Project Summary Cancer pain is complex, prevalent and has serious consequences for patients, family caregivers and healthcare systems. Inadequately managed cancer pain can be particularly problematic for patients coping with advanced, metastatic disease. Most symptom management occurs in the home setting, and family caregivers often play a key role in helping to manage cancer pain, but often find this task daunting and stressful. Complicating cancer pain management is the reality that opioids, a main-stay class of medications used to control serious cancer pain, are subject to increased scrutiny given well-publicized concerns about the national `opioid epidemic.' Now more than ever, it is imperative we understand how patients and family caregivers attempt to manage cancer pain at home so we can offer them personalized support to effectively and safely alleviate pain. Mobile and wireless technology (`smart health') can help support symptom management in the home setting, but must be carefully designed to account for the realities of patients and family caregivers coping with advanced disease. We hypothesize that individuals, and patient-family caregiver dyads, will display a unique `digital fingerprint' (or phenotype) of the advanced cancer pain experience – that if better understood can be utilized to inform and deliver personalized, timely interventions. The purpose of this study, which builds upon preliminary pilot work, is to deploy an unobtrusive smart health system, the Behavioral and Environmental Sensing and Intervention for Cancer (BESI-C), to monitor and describe – and ultimately to predict and help manage – the experience of advanced cancer pain in the home setting. BESI-C is comprised of wearable (smart watch) and environmental sensors that collect physiological, behavioral, and contextual data at the individual, dyad and home level that can be integrated to provide a comprehensive picture of a health related phenomenon. A unique feature of the BESI-C system is the ability of patients and caregivers to record and characterize cancer pain events from their own perspective using a custom application on their respective smart watch. Specifically, this observational research will analyze data collected via BESI-C from patient-family caregiver dyads recruited from an outpatient oncology palliative care clinic and a home hospice program, to develop comprehensive `digital phenotypes' of advanced cancer pain in the home setting. These digital phenotypes will characterize the frequency, intensity and impact on quality of life of pain events; monitor the use of pharmacological and non-pharmacological strategies and self-reported effectiveness; correlate environmental, contextual, behavioral and physiological sensor data with reported pain events; and evaluate concordance of patient and caregiver data. This research will also explore preferences for communicating collected data with patients, family caregivers and healthcare providers by creating and sharing data visualizations. Additionally, we will explore which sensing data are most predictive of breakthrough pain events to build parsimonious pain prediction algorithms.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $654,496 )
2025	2025	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	001	5	5/6/2025	NON-COMPETING CONTINUATION	$65,449
2025	2025	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	000	5	11/22/2024	NON-COMPETING CONTINUATION	$589,047
														Subtotal = $654,496

Issue Date FY: 2024 ( Subtotal = $676,844 )
2024	2024	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	000	4	11/29/2023	NON-COMPETING CONTINUATION	$609,160
2024	2024	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 EMMET ST N	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	001	4	5/3/2024	NON-COMPETING CONTINUATION	$67,684
														Subtotal = $676,844

Issue Date FY: 2023 ( Subtotal = $685,565 )
2023	2023	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	001	3	2/9/2023	NON-COMPETING CONTINUATION	$68,556
2023	2023	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	000	3	12/7/2022	NON-COMPETING CONTINUATION	$617,009
														Subtotal = $685,565

Issue Date FY: 2022 ( Subtotal = $698,545 )
2022	2022	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	001	2	4/20/2022	NON-COMPETING CONTINUATION	$69,855
2022	2022	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	000	2	11/2/2021	NON-COMPETING CONTINUATION	$628,690
														Subtotal = $698,545

Issue Date FY: 2021 ( Subtotal = $704,346 )
2021	2021	RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA	1001 N EMMET ST	CHARLOTTESVILLE	VA	22903	CHARLOTTESVILLE CITY	USA	Nursing Research	000	1	1/29/2021	NEW	$704,346
														Subtotal = $704,346

Grand Total All Awards = $3,419,796

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Characterizing the Complexity of Advanced Cancer Pain in the Home Context by Leveraging Smart Health Technology

Award Number: R01NR019639

ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/01/2021

PERIOD OF PERFORMANCE END DATE: 11/30/2026

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