Can patient reported measurements of pain be used to improve cancer pain management? A systematic review and meta-analysis

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Abstract

Purpose: Cancer pain is a distressing and complex experience. It is feasible that the systematic collection and feedback of patient-reported outcome measurements (PROMs) relating to pain could enhance cancer pain management. We aimed to conduct a systematic review of interventions in which patient-reported pain data were collected and fed back to patients and/or professionals in order to improve cancer pain control.

Methods: MEDLINE, EMBASE and CINAHL databases were searched for randomised and non-randomised controlled trials in which patient-reported data were collected and fed back with the intention of improving pain management by adult patients or professionals. We conducted a narrative synthesis. We also conducted a meta-analysis of studies reporting pain intensity.

Results: 29 reports from 22 trials of 20 interventions were included. PROM measures were used to alert physicians to poorly controlled pain, to target pain education and to link treatment to management algorithms. Few interventions were underpinned by explicit behavioural theories. Interventions were inconsistently applied or infrequently led to changes in treatment. Narrative synthesis suggested that feedback of PROM data tended to increase discussions between patients and professionals about pain and/or symptoms overall. Meta-analysis of 12 studies showed a reduction in average pain intensity in intervention group participants compared with controls (mean difference=−0.59 (95% CI −0.87 to −0.30)).

Conclusions: Interventions that assess and feedback cancer pain data to patients and/or professionals have so far led to modest reductions in cancer pain intensity. Suggestions are given to inform and enhance future PROM feedback interventions.
Original languageEnglish
Pages (from-to)373-382
Number of pages10
JournalBMJ Supportive & Palliative Care
Volume7
Issue number4
Early online date22 Nov 2016
DOIs
Publication statusPublished - 2017

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Pain Measurement
Pain Management
Meta-Analysis
Pain
Cancer Pain
MEDLINE
Databases
Physicians
Education
Patient Reported Outcome Measures
Therapeutics

Cite this

@article{d519611d8a8a4ff0880fe38a58a06b34,
title = "Can patient reported measurements of pain be used to improve cancer pain management? A systematic review and meta-analysis",
abstract = "Purpose: Cancer pain is a distressing and complex experience. It is feasible that the systematic collection and feedback of patient-reported outcome measurements (PROMs) relating to pain could enhance cancer pain management. We aimed to conduct a systematic review of interventions in which patient-reported pain data were collected and fed back to patients and/or professionals in order to improve cancer pain control.Methods: MEDLINE, EMBASE and CINAHL databases were searched for randomised and non-randomised controlled trials in which patient-reported data were collected and fed back with the intention of improving pain management by adult patients or professionals. We conducted a narrative synthesis. We also conducted a meta-analysis of studies reporting pain intensity.Results: 29 reports from 22 trials of 20 interventions were included. PROM measures were used to alert physicians to poorly controlled pain, to target pain education and to link treatment to management algorithms. Few interventions were underpinned by explicit behavioural theories. Interventions were inconsistently applied or infrequently led to changes in treatment. Narrative synthesis suggested that feedback of PROM data tended to increase discussions between patients and professionals about pain and/or symptoms overall. Meta-analysis of 12 studies showed a reduction in average pain intensity in intervention group participants compared with controls (mean difference=−0.59 (95{\%} CI −0.87 to −0.30)).Conclusions: Interventions that assess and feedback cancer pain data to patients and/or professionals have so far led to modest reductions in cancer pain intensity. Suggestions are given to inform and enhance future PROM feedback interventions.",
author = "Rosalind Adam and Burton, {Christopher D.} and Bond, {Christine M.} and {De Bruin}, Marijn and Peter Murchie",
note = "RA completed this review during a clinical academic fellowship funded by the Chief Scientist Office of the Scottish Government, grant reference RG12141-10.",
year = "2017",
doi = "10.1136/bmjspcare-2016-001137",
language = "English",
volume = "7",
pages = "373--382",
journal = "BMJ Supportive & Palliative Care",
issn = "2045-435X",
publisher = "BMJ Publishing Group",
number = "4",

}

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T1 - Can patient reported measurements of pain be used to improve cancer pain management? A systematic review and meta-analysis

AU - Adam, Rosalind

AU - Burton, Christopher D.

AU - Bond, Christine M.

AU - De Bruin, Marijn

AU - Murchie, Peter

N1 - RA completed this review during a clinical academic fellowship funded by the Chief Scientist Office of the Scottish Government, grant reference RG12141-10.

PY - 2017

Y1 - 2017

N2 - Purpose: Cancer pain is a distressing and complex experience. It is feasible that the systematic collection and feedback of patient-reported outcome measurements (PROMs) relating to pain could enhance cancer pain management. We aimed to conduct a systematic review of interventions in which patient-reported pain data were collected and fed back to patients and/or professionals in order to improve cancer pain control.Methods: MEDLINE, EMBASE and CINAHL databases were searched for randomised and non-randomised controlled trials in which patient-reported data were collected and fed back with the intention of improving pain management by adult patients or professionals. We conducted a narrative synthesis. We also conducted a meta-analysis of studies reporting pain intensity.Results: 29 reports from 22 trials of 20 interventions were included. PROM measures were used to alert physicians to poorly controlled pain, to target pain education and to link treatment to management algorithms. Few interventions were underpinned by explicit behavioural theories. Interventions were inconsistently applied or infrequently led to changes in treatment. Narrative synthesis suggested that feedback of PROM data tended to increase discussions between patients and professionals about pain and/or symptoms overall. Meta-analysis of 12 studies showed a reduction in average pain intensity in intervention group participants compared with controls (mean difference=−0.59 (95% CI −0.87 to −0.30)).Conclusions: Interventions that assess and feedback cancer pain data to patients and/or professionals have so far led to modest reductions in cancer pain intensity. Suggestions are given to inform and enhance future PROM feedback interventions.

AB - Purpose: Cancer pain is a distressing and complex experience. It is feasible that the systematic collection and feedback of patient-reported outcome measurements (PROMs) relating to pain could enhance cancer pain management. We aimed to conduct a systematic review of interventions in which patient-reported pain data were collected and fed back to patients and/or professionals in order to improve cancer pain control.Methods: MEDLINE, EMBASE and CINAHL databases were searched for randomised and non-randomised controlled trials in which patient-reported data were collected and fed back with the intention of improving pain management by adult patients or professionals. We conducted a narrative synthesis. We also conducted a meta-analysis of studies reporting pain intensity.Results: 29 reports from 22 trials of 20 interventions were included. PROM measures were used to alert physicians to poorly controlled pain, to target pain education and to link treatment to management algorithms. Few interventions were underpinned by explicit behavioural theories. Interventions were inconsistently applied or infrequently led to changes in treatment. Narrative synthesis suggested that feedback of PROM data tended to increase discussions between patients and professionals about pain and/or symptoms overall. Meta-analysis of 12 studies showed a reduction in average pain intensity in intervention group participants compared with controls (mean difference=−0.59 (95% CI −0.87 to −0.30)).Conclusions: Interventions that assess and feedback cancer pain data to patients and/or professionals have so far led to modest reductions in cancer pain intensity. Suggestions are given to inform and enhance future PROM feedback interventions.

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