Medication Usage Dates for Improved Reporting

Available with the v3.5.5 release of Chronic Pain Tracker, you now have the ability to define a Start Date and End Date for each custom Medication item in the Medication Tracker. Although this feature is optional, we do encourage our users to take advantage of it where applicable.

The feature has been added for two key reasons. First, it helps avoid mistakes at the time of entry creation, and second, it improves the accuracy of medication usage reporting. Let’s take a look at how to enable this feature and also how these benefits are achieved.

Defining Medication Usage Dates

To apply a Start or End Usage Date to your Medication items, you’ll need to open the Tracker List editing table for the Medication Tracker object. You can access this table either by (1) Going to the Settings tab, selecting Diary Preferences -> Medication Taken -> Edit Medication List, OR (2) Starting a new Diary Entry, adding the Medication Taken tracker to the entry, and selecting the “Edit Table Entries” from the medication table.

Once you have opened the Medication List, you can select the medication you wish to edit. In the example shown here, we’re going to edit the usage dates for “Dilaudid 4mg”. Once selected, you will see the details for this medication item. By default the Start/End dates will show as “Not Defined”.

Medication List Medication Details showing Usage Dates as Not Defined
Medication Tracker ListMedication Item Showing Start/End Dates as Not Defined

By tapping on the Start Date row, you will be presented with options for setting the date value. As you can see in this image, you have the option to (1) Manually Set the Date, (2) Automatically Set the Date, (3) Clear the Date, or (4) Cancel the Change. If you choose to Manually Set the Date, you will be presented with a Date Picker as shown in the second image below. Adjust the Month, Day & Year values to the appropriate date.

If you choose to use the Automatic option, the app will determine the Start/End Usage Date by looking up the First/Last time you used that particular medication and use that date as the new value. This usually will be sufficient, so we recommend using the automatic selection option first, and if necessary using the manual option to fine tune the date value.

If you set a date incorrectly (eg. setting an End Usage Date for the medication, but you are actually still taking it), you can use the Clear the Date option to reset the date to the “Not Defined” value.

MedicationAvailabilityStartDateEntryOptions MedicationAvailabilityStartDateManualSelection
Options for Setting the Start/End Date ValuesUsing the Date Picker to Set a Start Date Value

Once you’ve set the Start/End dates as desired, you will tap on the Done button in the upper left corner and then you’ll need to save the changes (green checkmark in upper right) to the Medication List.

For CPT users that have Device-to-Device Sync Enabled

We have identified a bug with v3.5.5 that prevents the proper saving of Tracker List changes when device-to-device sync is enabled. Although the changes appear to be saved, if you re-open the tracker list item, you’ll see the same previous values in place for that item. This bug is being addressed in the next update, but until then, you can do the following to avoid this problem.

Before you make any Tracker List changes, go to Settings tab -> Cloud Services -> Device Sync Services. Scroll to the bottom of the screen and tap on Turn Off Sync Services for Device to disabled the sync processing. Then you can make your Tracker List changes. Once those are complete, you can re-enable the Sync services. We do suggest going through the process of Uploading your Master DB to the cloud repository and Downloading the Master DB to your secondary devices after this step to ensure that all devices are starting from the same synchronized baseline.

Improved Medication Input with Usage Dates

One of the benefits of assigning usage dates to your medication items is that CPT can now help you avoid errors when creating new diary entries. This is done by giving you a warning message if you try to enter the usage of a medication for a diary entry that is before or after the associated usage date range.

For example, consider the situation where you have indicated that your “Dilaudid 4mg” medication was used from Nov 22, 2011 to Jan 10, 2014 via the new Start/End Dates. You then begin a new diary entry input for Feb 3, 2014. If you select the “Dilaudid 4mg” during that entry, you will receive a warning like the one shown below. This warning indicates that you are trying to indicate medication usage outside the defined timeframe.

MedicationAvailabilityEntryWarning
Warning Shown During Diary Entry When Selecting a Medication Beyond Its Availability Date Range

Improved Medication Reporting with Usage Dates

The more significant benefit of setting the usage dates comes when we look at CPT’s reporting features – specifically the Medication Tracker Summary Report. There are 4 standard graphs created per medication item in the current Summary Report format. Of these 4, the first graph, “Daily Medication Qty Totals per Day”, is the one where this change is most obvious.

The impact comes from the way we evaluate usage of the medication item. This is most easily explained by using the example of a breakthrough pain medication that is used a variable number of times per day – as needed for pain. There are some days where the pain is high and you may use the medication 3 or 4 times; maybe other days it will be moderate and it’s used only once or twice. Still other days, the good days, and you may not use the medication at all. It’s this last situation where the usage dates come into play.

Graph 1 - Daily Qty Totals when Start/End Dates are Not Defined Graph 2 - Daily Qty Total when Start/End Defined
Graph 1 – Daily Qty Totals when Start/End Dates are Not DefinedGraph 2 – Daily Qty Total when Start/End Defined

Graph 1 above shows a situation where usage dates are not defined for the “Dilaudid 4mg” medication item. You can see that there is consistent usage of the medication for the first half of the period, but then it drops to zero for each day. You can also see that there is a Medication Change milestone indicator at the point where the usage stops.

Looking at this you could assume that this was a situation where you were continuing to have the Dilaudid 4mg available for use but didn’t need it once you added some other medication to your treatment strategy (Scenario A). Or, perhaps this was a situation where you were using Dilaudid 4mg for the first part of the period, but then stopped using it in favor of a different medication (Scenario B). Although these situations are similar, they are unique and you’d probably want to report on them differently.

Graph 1 matches well to Scenario A since we continue to plot data points for the days after the medication change, and the moving average plot (green line) continues for the full width of the plot accounting for the reduced usage levels in the period after the medication change. The overall period average qty used indicated by the horizontal line labeled 1.1 tablets per day also reflects the average usage of Dilaudid 4mg during the period.

But for Scenario B when the usage of Dilaudid 4mg was discontinued after Jan 10, we would prefer a different view of the data, and that’s where Graph 2 is relevant. Here, we have the Jan 10, 2014 End Date defined in the Medication item. So now you can see that the Daily Qty data points past Jan 10 are shown, but they are grayed out indicating that the medication was not available during those days. You can also see that the moving average plot stops at the Jan 10 date since this was the last day the medication was available for use. And finally, the overall period average qty used is calculated only for the days when the medication was available and shows a 2.3 tablet per day use of the Dilaudid.

We believe the inclusion of Start/End Dates for the Medication items will allow you to generate more accurate summary data like those shown here. Both scenarios are realistic and therefore we saw a need to enable both to be reflected in the summary analysis and graphs. Enabling the definition of Start/End Dates now gives you the ability to deal with both of those situations.

Sorting your Medication Items

As of CPT v3.5.5 (released Feb 20, 2014), you have the ability to define a manual sort order for your list of Medication Items. This can be helpful if you have a large number of items in the Medication table and want to move current meds towards the top of the list.

Using this feature is quite easy. To begin, open the Medication Tracker List by either:

  • go to the Settings tab -> Diary Preferences -> Medication Taken – Edit Medication List, OR
  • create/edit a diary entry, add the Medication Tracker and select “Edit Table Entries” at the bottom of the list

With the Medication list open, you’ll see that each table entry will include a sort order control on the far right side of the row. It’s the icon with the three stacked gray bars. To change the position of an item in the table, tap/hold on the icon and drag the item up or down in the list. Once it’s in the location you want, just let go of the item and it will pop into place.

Once you have manually changed the sort order of the table, the items will remember their new positions and will display in this order for all new diary entries. As you add new Medication items, you can continue to adjust the sort order as needed.

scrnMedicationTrackerListSortOrderControls

Customize Your Diary Entry Workflow

Simplifying with Tracker Collections

Scrn TrackerCollectionBuilder04

If you haven’t tried defining and using a Tracker Collection, you’re missing
out on what may be a great time saver for your Diary Entry process. The
following items will give some examples of how to use Tracker Collections.

Normally when creating a new Diary Entry, you select the Tracker
items you want to include. That’s great for giving you the flexibility to
choose only those items that you need, but what if you always want to use the
same items in your Diary Entry? Then that extra flexibility can slow you down. But
with Tracker Collections, you can adapt the Diary Entry workflow to satisfy just about any approach you want to take..

Defining a Tracker Collection

To create a Tracker Collection, simply (1) Select the Tracker items you want
to include and (2) Then tap the “New Collection” button. You’ll be asked to
provide a unique name for the collection. Once saved, you can view the Tracker
Collection by (3) Tapping the “Apply a Collection” button.

width=”33%”> width=”33%”> width=”33%”> Arial,Helvetica,sans-serif;font-size: 10pt”>(1) Select your Tracker Items (2) Tap “New Collection” and Save (3) Tap “Apply a Collection” to review

 

Using the Tracker Collection

Once defined, you’re ready to start using the new Tracker Collection. There
are a few ways to use a Tracker Collection in your Diary Entry workflow. Which
one is right for you will depend on your personal needs, but we’ll illustrate
each one here starting with the least degree of automation to the greatest.

Manual Tracker Selection

Although this workflow doesn’t even use Tracker Collection, I’m still including this workflow in our examples for the sake of completeness. In this scenario, the user wants to manually select the Trackers for each Diary Entry. This gives the utmost in flexibility and customization, and for some folks that’s a blessing.

When you first start using CPT, this is the workflow you’re beginning with. Now let’s take a look at some alternative workflows that might better fit your needs.

Occasional Usage

In this example workflow, let’s consider the situation where you sometimes
create a Diary Entry that utilizes the same group of Tracker items. Maybe it’s
your first entry each day or the after dinner entry, etc. The point is that
normally you use the manual selection of Tracker Items to build your Diary
Entry, but there are those times where you are selecting the same items as
before.

For those entries where you have previously defined a Tracker Collection,
simply tap the Apply a Collection when you open the Tracker Selection screen.
This will open the Collection table and you can select the Tracker Collection
you want to apply. With this workflow, you save a few taps since the items are
already grouped together in the Collection.

Regular Usage

Now let’s consider a situation where you’ve been able to define a Tracker
Collection for each of the types of entries you create. Maybe you’ve created
one for a morning entry, one for breakthrough pain entries, one for bedtime,
etc. In this scenario, you almost always select one of your predefined
Collections rather than manually selecting Tracker items.

If this is the case, you can change a setting which will automatically
display the Tracker Collection table rather than the Tracker Selection table
when creating a new Diary Entry. This saves another tap since you don’t have to
choose the “Apply a Collection” button.

To enable this workflow, go to the Settings tab, then Diary Preferences,
then Tracker Collection Prefs. Set the “Jump to Collection Table First” to ON.
Now you will automatically jump to the Collection table when creating a new
entry. That said, if you need to, you can always manually change the Trackers
included in the Diary Entry just like before.

Default Diary Entry Format – NEW in v3.4

For the ultimate in automation, let’s now consider a workflow where you want
to use the same group of Tracker items for every Diary Entry you create. If
this is the case, then you can define one of your Tracker Collections as the
“Default” Diary Entry structure. All new Diary Entries will be created with
those Tracker items already added to the Diary Entry, so you can jump right
into data entry mode.

Scrn TrackerCollectionBuilder04
This is a new feature now available in v3.4 and later. To enable it, go to the Tracker Collection table and tap
the “Make Default” button on one of your Tracker Collections. That’s it. Now
each new Diary Entry will contain the Tracker items from that Collection. As in
the other workflows, you can still go back and modify the Tracker items after
the fact, so you’re never limited by the automation.

Speed up Diary Entry creation with “Copy Last”

For many pain sufferers, pain descriptions, locations, etc may not vary too much from hour to hour or even day to day. In these situations it can be tedious to create the same Diary Entry time and time again. That’s where the “Copy Last” feature comes into play. It can make the process of creating your Diary Entry much more streamlined. Let’s have a look at how it works.

ScrnDiaryEntryCopyLastButton

As an example, let’s say that you Pain Description terminology and your Pain Location Map would often be the same from entry to entry. Rather than selecting the same 4 or 5 pain descriptions from the table each time, or painting the same Pain Location Map each time, you can use the Copy Last button in the Tracker title bar (shown to the right) to copy the data from your previous entry into the current entry.

In some cases, this may be all you need to do and you can move on to the next item in the entry. But, you always have the option of modifying what was copied into the new entry so even if your pain has changed a bit from your previous entry, using the Copy Last button can still have benefits. As an example, consider the Pain Location Mapping Tracker. For complex pain patterns it can take some effort to get the pain map just right. Using the Copy Last button allows you to bring your previous entry’s map forward so that you can simply fine tune for your current pain profile rather than starting from scratch again.

As you can see in the image, the Copy Last button is present in the title bar for each Tracker, so this functionality exists for all the Diary Entry tools. You can choose to use this button during the Diary Entry creation process, or if you find that you are constantly using the button for a particular Tracker, you may want to set the Copy Last option as the default behavior for a particular Tracker. Again let’s use the Pain Description Tracker as our example.

ScrnSettingsDescriptionCopyLastEntry

Going to the Settings tab and selecting Diary Preferences, then tapping Pain Description will bring you to the default settings for this Tracker. Here you can see the first option is for “Default from Last Entry”. Setting this option to ON will automatically trigger the Copy Last process whenever you add that Tracker to a new Diary Entry.

After making the change in the Settings tab, try creating a new Diary Entry and add the Pain Description Tracker to the entry. You’ll notice that the table will immediate display the selections from your previous entry. The table still remains fully editable, so if your pain has changed slightly, you still have the ability to make modifications before saving the entry.

I hope this information is helpful to those of you that have some degree of consistency in your daily pain profiles. If you have questions or suggestions about how we can make the Diary Entry process even more efficient, please contact us via one of our support request options and let us know.

Does Weather Impact Your Pain?

Weather’s impact on your body

As the leaves begin to change color, and the cooler breezes begin to blow, many of us begin to prepare for the increased pain cold, wet weather can bring to our bodies. Weather triggered pain is a significant source of chronic pain for millions of people.

But how sensitive are you to weather changes? Was your increased pain last week due to the cold front that blew through, or are there other issues contributing to your pain? They are important questions and ones your doctor has probably asked you a number of times. How do you really know the answer?

New Weather Tracker Tool in CPT

Now, with Chronic Pain Tracker you can effectively track and analyze your response to changing weather conditions to determine how much of an impact they have on your chronic pain levels. The new Weather Tracker is easily added to your pain diary entries.

Using worldwide weather data provided by Weather Underground, the Weather Tracker records key factors like temperature, humidity levels, barometric pressure, and precipitation. Combined with the existing Pain Level Tracker in CPT you can objectively document your response to the changing weather conditions.

 

Weather Analysis and Reporting

When you prepare for your next doctor’s appointment, use Chronic Pain Tracker’s Summary Report feature to automatically aggregate and analyze all of your pain diary entries to create a comprehensive summary of your recent pain profile. The new Weather Tracker section of this report provides six new graphical representations of how your pain levels respond to changes in the weather. These graphs include the following studies:

Temperature & Pain Levels vs Time

This graph charts the rising and falling of Temperature over time combined with an overlay of your pain levels for the same period. Comparing the two graphs can provide hints about how closely linked your changes in pain level are to overall temperature. This is probably best compared over longer periods of time where you can detect seasonal impact of moving from summer to fall to winter and looking for corresponding increases/decreases in pain levels.

Humidity & Pain Levels vs Time

As the rain begins to move in, humidity levels rise and for many, so does their pain level. This graph plots the changes in humidity levels over time and also has the pain level overlay which can be used for comparison.

Barometric Pressure & Pain Levels vs Time

Many people can feel bad weather moving in. This is believed to be caused by a reduction in the barometric pressure allowing injured or arthritic joints to swell and cause pain. This graph can help identify to what degree your pain is influenced by changing pressure levels. As before, the changes are shown over the reporting time period with the pain level overlay available for comparison.

Pain Level Range vs Weather Condition

For each Weather Tracker entry, an overall definition of the current weather conditions is recorded (eg. Sunny, Light Rain, Snowing, etc). By aggregating all of your Weather Tracker entries along with your recorded Pain Levels, CPT is able to provide an analysis of your range of pain for each type of weather condition.

The graph shows a bar for each weather condition which represents the full range or recorded pain levels during that condition, and a marker (green line) which represents the average pain level across all entries for that condition. The conditions are then displayed in order of decreasing average pain level. This means that the conditions where you experienced the most pain (on average) are shown on the left side of the graph.

Pain Level Range vs Humidity Levels

In a similar manner to the Weather Condition graph, this graph aggregates all of your Weather Tracker and Pain Level Tracker entries and divides them based on Relative Humidity Level ranges. Again, the bars represent the high to low pain levels experienced and the green line shows the average pain level experienced when the humidity was within a certain range.

Pain Level Range vs Pressure Trend Direction

Finally, the last graph looks at not the exact Pressure Level, but rather what direction the Barometric Pressure level was trending when the diary entry was created. For those people that experience more pain before a storm arrives, you would expect the average pain levels to be higher during times of falling pressure levels. What will your data show?

We encourage you to give the new CPT Weather Tracker a try today. With a single click you can add it to your Diary Entry (from the Tracker selection screen) and it will use the location services within your device to determine your location which is then used to download your local weather conditions. (Note: Your location data is only used for the purposes of gathering this weather data).

Ensure Diary Security with Pattern Lock Feature

Diary Security made Simple

IPhoneCompositePatternLock

Holding sensitive medical information in CPT makes Diary Security a valid concern. Our new Pattern Lock feature helps to control access to your Diary information, but without weighing the app down with cumbersome passwords or numerical codes. This feature is ideal for anyone having legitimate concerns about the confidentiality of their health information saved within the app.

It’s also perfect for moms and dads that let the little ones play on their phones by preventing inadvertent changes to your Pain Diary.

What is Pattern Lock?

What really differentiates this feature from other password or numerical code access systems is that it is so easy and quick to use. You don’t have to fool with a keyboard or numerical pad. And let’s face it. If diary security makes it hard to get into the app, you’re not going to use it. So we tried to make this as simple as possible.

Just use your finger to connect a series of points on the screen. The pattern that this traces out is your “password”. You can make the actual code as simple or as complex as you’d like.

If you suffer from arthritis or stiffness/pain in the hand, than this method of diary security is going to be much easier than typing out a password to get into the app.

Enabling Pattern Lock

To enable the Pattern Lock security, you need to go to the Settings tab, then choose Application Options, then Pattern Lock Setup. Follow the directions there to enable the diary security option. Once enabled, this is also where you will come if you want to disable the diary security.

Once enabled, the Pattern Lock screen will be displayed whenever the app is first launched AND whenever it comes out of the multi-tasking background. The correct pattern must be entered in order to gain access to the app, so don’t forget your pattern code!