Authors
- Tim Luckett1,
- Melanie Lovell2,
- Jane Phillips1,
- Meera Agar1,
- Lawrence Lam1,
- Nikki McCaffrey3,
- Frances Boyle4,
- John Stubbs5,
- Tim Shaw4,
- David Currow3,
- Annmarie Hosie1,
- Patricia M Davidson6
- University of Technology Sydney (UTS)1,
- HammondCare2,
- Flinders University3,
- University of Sydney4,
- Can Speak the voice of the cancer community Australia5,
- Johns Hopkins University6
2016
Excerpt
Introduction/Background/Significance: Cancer pain is under-‐treated internationally due to barriers at the levels of the healthcare system (e.g. lack of care coordination), clinician (e.g. lack of expertise) and patient (e.g. reluctance to report pain). The authors adapted international guidelines for Australia and made these available on the Cancer Council Australia Cancer Guidelines Wiki to ensure access and currency and enable user feedback. However, research suggests that, without targeted strategies guidelines are unlikely to be widely used.
Aims/Objectives/Hypotheses: To evaluate the effectiveness and cost-effectiveness of a suite of cancer pain guideline implementation resources designed to improve pain outcomes for patients attending ambulatory oncology and palliative care.
Approach/Methods/Procedure: Evaluation is underway via a stepped wedge cluster randomised controlled trial from 2015 to 2018. Each of 8 oncology and palliative care outpatient services will be observed for 4 months providing usual care and then 4 months after the strategies are implemented. Strategies will include pain screening and audit/feedback (service level), health professional education (clinician level) and patient-held resources (patient-level). Outcomes will be pain severity, quality of life, caregiver experience, patient empowerment and healthcare costs.
Results/Findings/Outcomes: The study is currently recruiting.
Discussion/Implications for Practice: If found effective, the strategies evaluated in this trial will be made freely available on the Cancer Council of Australia Cancer Guideline Wiki. A dissemination strategy will be devised by the team in partnership with peak bodies. Consumer advocacy will play an especially important role in promoting use of the pathways.
Conclusion: Better management of pain has potential to increase quality of life and caregiver experience but targeted strategies are needed to implement evidence-based care.
Funding Acknowledgement: National Breast Cancer Foundation.
Aims/Objectives/Hypotheses: To evaluate the effectiveness and cost-effectiveness of a suite of cancer pain guideline implementation resources designed to improve pain outcomes for patients attending ambulatory oncology and palliative care.
Approach/Methods/Procedure: Evaluation is underway via a stepped wedge cluster randomised controlled trial from 2015 to 2018. Each of 8 oncology and palliative care outpatient services will be observed for 4 months providing usual care and then 4 months after the strategies are implemented. Strategies will include pain screening and audit/feedback (service level), health professional education (clinician level) and patient-held resources (patient-level). Outcomes will be pain severity, quality of life, caregiver experience, patient empowerment and healthcare costs.
Results/Findings/Outcomes: The study is currently recruiting.
Discussion/Implications for Practice: If found effective, the strategies evaluated in this trial will be made freely available on the Cancer Council of Australia Cancer Guideline Wiki. A dissemination strategy will be devised by the team in partnership with peak bodies. Consumer advocacy will play an especially important role in promoting use of the pathways.
Conclusion: Better management of pain has potential to increase quality of life and caregiver experience but targeted strategies are needed to implement evidence-based care.
Funding Acknowledgement: National Breast Cancer Foundation.