Advertisement

The Effect of Remote-Based Monitoring and Education Program on Cancer Pain Management in an Outpatient Pain Clinic

      Highlights

      • Pain is a challenging component among patients with cancer, and controlling pain is among the primary goals for patients and healthcare providers.
      • Implementing remote-based monitoring and education programs can improve the pain management provided and decrease the pain interferences with patients’ activities and daily lives.
      • The results were statistically significant in overcoming the attitudinal barriers and improving levels of medication adherence among patients complaining of cancer-related pain.

      Abstract

      Background

      Pain is one of the most feared consequences of cancer for patients and their families. Many barriers may hinder optimal pain management.

      Aim

      Examine the effect of remote-based monitoring and education program on cancer pain management, patient-related barriers, and level of adherence to pain medication.

      Methods

      A sample of 134 patients was assigned to two groups; 68 in the intervention group and 66 in the control. The intervention group received three educational sessions by telephone. Both groups completed questionnaires at baseline and one month after the initial visit.

      Results

      Significant differences were found between the groups in the levels of pain right now (p = .030), pain at its least (p = .016), and in the percentage of achieved pain relief (p = .048). Moreover, the intervention group experienced lower levels of interference with their general activity (p = < .001), mood (p = .011), and normal work (p = .004) post-intervention. The Attitudinal Barriers differences were statistically significant in the total mean (p = < .001), and the subscales of physiological effects (p = < .001), fatalism (p = < .001), communication (p = < .001), harmful effects (p = < .001). Participants in the intervention group exhibited higher adherence levels (p = .001).

      Conclusions

      Patients suffering from cancer-related pain can benefit from remote-based monitoring and education programs to improve pain management outcomes, overcome barriers, and increase adherence. Further research is needed to investigate the different available educational methods and long-term effects.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Al-Atiyyat N.M.H.
        • Vallerand A.H.
        Patient-related attitudinal barriers to cancer pain management among adult Jordanian patients.
        European Journal of Oncology Nursing. 2018; 33: 56-61
        • Al Qadire M.
        Patient-related barriers to cancer pain management in Jordan.
        Journal of Pediatric Hematology/Oncology. 2012; 34: S28-S31
        • Al Qadire M.
        • Tubaishat A.
        • Aljezawi M.E.M.
        Cancer pain in Jordan: prevalence and adequacy of treatment.
        International Journal of Palliative Nursing. 2013; 19: 125-130
        • Ballout S.
        • Noureddine S.
        • Huijer H.A.S.
        • Kanazi G.
        Psychometric evaluation of the arabic brief pain inventory in a sample of Lebanese cancer patients.
        Journal of Pain and Symptom Management. 2011; 42: 147-154
        • Beyhaghi H.
        • Reeve B.B.
        • Rodgers J.E.
        • Stearns S.C.
        Psychometric properties of the four-item Morisky Green Levine Medication Adherence Scale among Atherosclerosis Risk in Communities (ARIC) study participants.
        Value in Health. 2016; 19: 996-1001
        • Cleeland C.S.
        • Ryan K.M.
        Pain assessment: global use of the Brief Pain Inventory.
        Annals of the Academy of Medicine, Singapore. 1994; 23: 129-138
        • Daut R.L.
        • Cleeland C.S.
        • Flanery R.C.
        Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases.
        Pain. 1983; 17: 197-210
        • Deandrea S.
        • Corli O.
        • Consonni D.
        • Villani W.
        • Greco M.T.
        • Apolone G.
        Prevalence of breakthrough cancer pain: a systematic review and a pooled analysis of published literature.
        Journal of Pain and Symptom Management. 2014; 47: 57-76
        • D'emeh W.M.
        • Yacoub M.I.
        • Darawad M.W.
        • Al-Badawi T.H.
        • Shahwan B.
        Pain-related knowledge and barriers among Jordanian nurses: A national study.
        Health. 2016; 8: 548-558
        • Dewolf L.
        • Koller M.
        • Velikova G.
        • Johnson C.
        • Scott N.
        • Bottomley A.
        • EORTC Quality of Life Group
        EORTC Quality of Life Group translation procedure.
        3rd ed. EORTC Quality of Life Group, Brussels, Belgium2009
        • Elhadary S.M.
        • Saad H.A.
        Patients' and nurses' barriers regarding cancer pain management: strategies to overcome.
        Journal of Health, Medicine and Nursing. 2017; 42: 71-81
        • Faul F.
        • Erdfelder E.
        • Buchner A.
        • Lang A.
        Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses.
        Behavior Research Methods. 2009; 41: 1149-1160
        • Ferreira-Valente M.A.
        • Ribeiro J.L.P.
        • Jensen M.P.
        Further validation of a Portuguese version of the brief pain inventory interference scale.
        Clínica y Salud. 2012; 23: 89-96
        • Furler L.
        [Validity and reliability of the pain questionnaire" Brief Pain Inventory". A literature research.] Article in German.
        Pflege Zeitschrift. 2013; 66: 546-550
        • Glowacki D.
        Effective pain management and improvements in patients' outcomes and satisfaction.
        Critical Care Nurse. 2015; 35: 33-41
        • Gunnarsdottir S.
        • Donovan H.S.
        • Serlin R.C.
        • Voge C.
        • Ward S.
        Patient-related barriers to pain management: the Barriers Questionnaire II (BQ-II).
        Pain. 2002; 99: 385-396
        • Gunnarsdottir S.
        • Serlin R.C.
        • Ward S.
        Patient-related barriers to pain management: the Icelandic Barriers Questionnaire II.
        Journal of Pain and Symptom Management. 2005; 29: 273-285
        • Jahn P.
        • Kuss O.
        • Schmidt H.
        • Bauer A.
        • Kitzmantel M.
        • Jordan K.
        • Krasemann S.
        • Landenberger M.
        Improvement of pain-related self-management for cancer patients through a modular transitional nursing intervention: a cluster-randomized multicenter trial.
        Pain. 2014; 155: 746-754
        • Kim H.S.
        • Shin S.J.
        • Kim S.C.
        • An S.
        • Rha S.Y.
        • Ahn J.B.
        • Cho B.C.
        • Choi H.J.
        • Sohn J.H.
        • Kim H.S.
        • Chung H.C.
        • Kim J.H.
        • Roh J.K.
        • Lee S.
        Randomized controlled trial of standardized education and telemonitoring for pain in outpatients with advanced solid tumors.
        Supportive Care in Cancer. 2013; 21: 1751-1759
        • Kini V.
        • Ho P.M.
        Interventions to improve medication adherence: A review.
        JAMA. 2018; 320: 2461-2473
        • Koh S.J.
        • Keam B.
        • Hyun M.K.
        • Seo Ju
        • Uk Park J.
        • Oh K.
        • S Y.
        • Ahn J.
        • Lee J.Y.
        • Kim J
        Cancer pain management education rectifies patients' misconceptions of cancer pain, reduces pain, and improves quality of life.
        Pain Medicine. 2018; 19: 2546-2555
        • Kumar S.P.
        Utilization of brief pain inventory as an assessment tool for pain in patients with cancer: A focused review.
        Indian Journal of Palliative Care. 2011; 17: 108-115
        • Kwon J.H.
        Overcoming barriers in cancer pain management.
        Journal of Clinical Oncology. 2014; 32: 1727-1733
        • Liang S.Y.
        • Wu S.F.
        • Tsay S.L.
        • Wang T.J.
        • Tung H.H.
        Prescribed opioids adherence among Taiwanese oncology outpatients.
        Pain Management Nursing. 2013; 14: 155-160
        • Meghani S.H.
        • Knafl G.J.
        Patterns of analgesic adherence predict health care utilization among outpatients with cancer pain.
        Patient Preference and Adherence. 2016; 10: 81-98
        • Morisky D.E.
        • Green L.W.
        • Levine D.M.
        Concurrent and predictive validity of a self-reported measure of medication adherence.
        Medical Care. 1986; 24: 67-74
        • Naegeli A.N.
        • Tomaszewski E.L.
        • Al Sawah S.
        Psychometric validation of the Brief Pain Inventory-Short Form in patients with systemic lupus erythematosus in the United States.
        Lupus. 2015; 24: 1377-1383
        • Oldenmenger W.H.
        • Sillevis Smitt P.A.
        • de Raaf P.J.
        • van der Rijt C.C.
        Adherence to analgesics in oncology outpatients: focus on taking analgesics on time.
        Pain Practice. 2017; 17: 616-624
        • Prevost V.
        • Delorme C.
        • Heutte N.
        • Leconte A.
        • Bechet C.
        • Licaj I.
        • Bignon R.
        • Bisson C.
        • Cauchin S.
        • Gicquère M.
        • Grach M.C.
        • Guillaumé C.
        • Le Garrec J.
        • Ropartz M.C.
        • Roux N.
        • Sep Hieng V.
        • Le Chevalier A.
        • Clarisse B.
        Evaluation of patients’ needs to design and assess a patient education program in cancer pain.
        Journal of Pain Research. 2019; 12: 1813-1823
        • Raj S.X.
        • Thronaes M.
        • Brunelli C.
        • Hjermstad M.J.
        • Klepstad P.
        • Kaasa S.
        A cross-sectional study on prevalence of pain and breakthrough pain among an unselected group of outpatients in a tertiary cancer clinic.
        Supportive Care in Cancer. 2014; 22: 1965-1971
        • Savas M.
        • Bayraktar-Ekincioglu A.
        • Celebi N.
        An evaluation of cancer patients' opinions about use of opioid analgesics and the role of clinical pharmacist in patient education in Turkey.
        International Journal of Clinical Pharmacy. 2021; 43: 375-382
        • Shadish W.R.
        • Cook T.D.
        • Campbell D.T.
        Experimental and quasi-experimental designs for generalized causal inference.
        Houghton Mifflin, Boston2002
        • Song C.Y.
        • Lin S.F.
        • Huang C.Y.
        • Wu H.C.
        • Chen C.H.
        • Hsieh C.L.
        Validation of the brief pain inventory in patients with low back pain.
        Spine. 2016; 41: E937-E942
        • Thomas M.L.
        • Elliott J.E.
        • Rao S.M.
        • Fahey K.F.
        • Paul S.M.
        • Miaskowski C.
        A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management.
        Oncology Nursing Forum. 2012; 39: 39-49
        • Yeager K.A.
        • Williams B.
        • Bai J.
        • Cooper H.L.
        • Quest T.
        • Meghani S.H.
        • Bruner D.W.
        Factors related to adherence to opioids in black patients with cancer pain.
        Journal of Pain and Symptom Management. 2019; 57: 28-36
        • van den Beuken-van M.H.
        • Hochstenbach L.M.
        • Joosten E.A.
        • Tjan-Heijnen V.C.
        • Janssen D.J.
        Update on prevalence of pain in patients with cancer: Systematic review and meta-analysis.
        Journal of Pain and Symptom Management. 2016; 51: 1070-1090
        • van der Peet E.H.
        • van den Beuken-van M.H.
        • Patijn J.
        • Schouten H.C.
        • van Kleef M.
        • Courtens A.M.
        Randomized clinical trial of an intensive nursing-based pain education program for cancer outpatients suffering from pain.
        Supportive Care in Cancer. 2009; 17: 1089-1099
        • Ward S.E.
        • Goldberg N.
        • Miller-McCauley V.
        • Mueller C.
        • Nolan A.
        • Pawlik-Plank D.
        • Robbins A.
        • Stormoen D.
        • Weissman D.E.
        Patient-related barriers to management of cancer pain.
        Pain. 1993; 52: 319-324
        • Zech D.F.
        • Grond S.
        • Lynch J.
        • Hertel D.
        • Lehmann K.A.
        Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study.
        Pain. 1995; 63: 65-76
        • Zeng D.
        • Li K.
        • Lin X.
        • Mizuno M.
        Attitudinal barriers to pain management and associated factors among cancer patients in mainland China: Implications for cancer education.
        Journal of Cancer Education. 2020; 35: 284-291
        • Zhou L.
        • Liu X.L.
        • Tan J.Y.
        • Yu H.P.
        • Pratt J.
        • Peng Y.Q.
        Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: A systematic review.
        International Nursing Review. 2015; 62: 218-230
        • Zuccaro S.M.
        • Vellucci R.
        • Sarzi-Puttini P.
        • Cherubino P.
        • Labianca R.
        • Fornasari D.
        Barriers to pain management.
        Clinical Drug Investigation. 2012; 32: 11-19