UCI Sue & Bill Gross School of Nursing Professor Michelle Fortier has been awarded a $3.195 M grant from the National Cancer Institute to continue her research and development of a novel pain and symptom management tool for children with cancer.

Michelle A. Fortier

Michelle A. Fortier, PhD Associate Professor

Dr. Fortier is a pediatric psychologist who specializes in pain management in children. “Historically, when cancer treatment for children was primarily inpatient, and nurses were in charge, pain management was pretty effective. However, as health care delivery has changed, today we see that the majority of children with cancer are being treated on an outpatient basis. This is great for quality of life, but it shifts the burden of pain management to parents and caregivers,” observed Dr. Fortier. In addition, the shift to more outpatient cancer treatment has resulted in less accurate symptom assessment information collected by clinicians, which can negatively impact the patient’s experience and outcomes.

Dr. Fortier saw a need for pain management in children’s cancer care to evolve with the shift to more outpatient care. She and her colleagues researched extensively the needs of the patients, their families, and clinicians. Dr. Fortier says that, initially, she was focused on developing a more accurate and useful pain and symptom assessment tool. However, during the process of conceptualizing the reporting tool, she thought, “Why are we limiting this tool to just assessment? I have the skills to help children reduce their pain. We should harness that, and incorporate it into this tool. To my knowledge, there was nothing like this out there. Why not do both assessment and intervention?”

With a team of researchers, Dr. Fortier developed “Pain Buddy,” an app that incorporates validated patient-reported measures of pain and symptoms, uses an electronic server to deliver child-reported symptom data in real time to healthcare providers, incorporates symptom alert algorithms to notify providers when a child has reported clinically significant symptoms, and teaches children empirically-supported cognitive and behavioral skills for pain management.

A small pilot study of 50 patients demonstrated that Pain Buddy reduces pain severity in children undergoing outpatient cancer treatment. With the NCI grant, Dr. Fortier and her colleagues will study Pain Buddy’s effectiveness at two locations: CHOC Children’s Hospital in Orange, CA, and St. Jude Children’s Research Hospital in Memphis, TN. While the primary aim of the study is to determine if Pain Buddy is more effective than attention control in reducing pain severity among children ages 8-18 years old undergoing outpatient cancer treatment, Dr. Fortier believes that Pain Buddy has potential applications in the area of pain management for many other populations in the future.