Patient and caregiver experiences of utilising out of hours primary care for cancer pain

Research output: Contribution to journalAbstract

Abstract

Background/introduction: Pain is the most frequent complication of cancer. Cancer pain control is often suboptimal despite effective treatments being available. Cancer pain can result in increased healthcare utilization including unscheduled and emergency presentations. The circumstances of out of hours (OOH) primary care use by patients with cancer pain are poorly understood. Cancer pain management may be an appropriate and necessary function of an OOH service. It is also conceivable that some OOH contacts are undesirable and could reflect suboptimal baseline pain management or inadequate anticipatory planning.
Research question: What are the circumstances of primary care OOH use by patients who require assistance with cancer pain management?
Methods: OOH computerised records in Grampian we researched for Read codes relating to cancer on a weekly basis.Adults who had made contact for help with cancer pain were invited to participate in a semi structured interview, with or without a caregiver. Interviews were transcribed verbatim and analysed using Framework analysis.
Results: Face-to-face interviews were conducted with 11 patients, and four caregivers (joint interviews). Six themes emerged: (1) Making sense of pain and predicting its course.
Participants made a judgement about pain in the context of their underlying illness. (2) Beliefs about analgesics. Participants had concerns about using analgesics. (3) Daytime access.Arrangements were often in place for priority access. (4) Continuity of care. Participants valued personal continuity for scheduled care but not unscheduled care. (5) Barriers and facilitators to help-seeking. The presence of a caregiver particularly facilitated help-seeking; and (5) Satisfaction with OOH care. Structured anticipatory care summaries assisted help-seeking, OOH access, and improved patient satisfaction.Conclusions: Patient’s beliefs and understanding about cancer pain and analgesics should be explored during scheduled care.Barriers to help-seeking should be addressed. A structured palliative care summary can improve the OOH primary care experience.
Original languageEnglish
Pages (from-to)19
Number of pages1
JournalEuropean Journal of Cancer Care
Volume24
Issue numberSupplement 2
Early online date3 Sep 2015
DOIs
Publication statusPublished - Sep 2015

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Caregivers
Primary Health Care
Pain Management
Interviews
Analgesics
Continuity of Patient Care
Pain
Cancer Pain
Patient Satisfaction
Palliative Care
Neoplasms
Emergencies
Joints
Delivery of Health Care
Research

Keywords

  • Cancer pain
  • Out of hours primary care
  • Patient experience
  • Caregiver experience

Cite this

@article{39d57917f8a34f1787dedffedf2ac1c5,
title = "Patient and caregiver experiences of utilising out of hours primary care for cancer pain",
abstract = "Background/introduction: Pain is the most frequent complication of cancer. Cancer pain control is often suboptimal despite effective treatments being available. Cancer pain can result in increased healthcare utilization including unscheduled and emergency presentations. The circumstances of out of hours (OOH) primary care use by patients with cancer pain are poorly understood. Cancer pain management may be an appropriate and necessary function of an OOH service. It is also conceivable that some OOH contacts are undesirable and could reflect suboptimal baseline pain management or inadequate anticipatory planning.Research question: What are the circumstances of primary care OOH use by patients who require assistance with cancer pain management?Methods: OOH computerised records in Grampian we researched for Read codes relating to cancer on a weekly basis.Adults who had made contact for help with cancer pain were invited to participate in a semi structured interview, with or without a caregiver. Interviews were transcribed verbatim and analysed using Framework analysis.Results: Face-to-face interviews were conducted with 11 patients, and four caregivers (joint interviews). Six themes emerged: (1) Making sense of pain and predicting its course.Participants made a judgement about pain in the context of their underlying illness. (2) Beliefs about analgesics. Participants had concerns about using analgesics. (3) Daytime access.Arrangements were often in place for priority access. (4) Continuity of care. Participants valued personal continuity for scheduled care but not unscheduled care. (5) Barriers and facilitators to help-seeking. The presence of a caregiver particularly facilitated help-seeking; and (5) Satisfaction with OOH care. Structured anticipatory care summaries assisted help-seeking, OOH access, and improved patient satisfaction.Conclusions: Patient’s beliefs and understanding about cancer pain and analgesics should be explored during scheduled care.Barriers to help-seeking should be addressed. A structured palliative care summary can improve the OOH primary care experience.",
keywords = "Cancer pain, Out of hours primary care, Patient experience, Caregiver experience",
author = "Rosalind Adam and Hall, {Susan Jane} and Peter Murchie",
year = "2015",
month = "9",
doi = "10.1111/ecc.12373",
language = "English",
volume = "24",
pages = "19",
journal = "European Journal of Cancer Care",
issn = "0961-5423",
publisher = "Wiley-Blackwell",
number = "Supplement 2",

}

TY - JOUR

T1 - Patient and caregiver experiences of utilising out of hours primary care for cancer pain

AU - Adam, Rosalind

AU - Hall, Susan Jane

AU - Murchie, Peter

PY - 2015/9

Y1 - 2015/9

N2 - Background/introduction: Pain is the most frequent complication of cancer. Cancer pain control is often suboptimal despite effective treatments being available. Cancer pain can result in increased healthcare utilization including unscheduled and emergency presentations. The circumstances of out of hours (OOH) primary care use by patients with cancer pain are poorly understood. Cancer pain management may be an appropriate and necessary function of an OOH service. It is also conceivable that some OOH contacts are undesirable and could reflect suboptimal baseline pain management or inadequate anticipatory planning.Research question: What are the circumstances of primary care OOH use by patients who require assistance with cancer pain management?Methods: OOH computerised records in Grampian we researched for Read codes relating to cancer on a weekly basis.Adults who had made contact for help with cancer pain were invited to participate in a semi structured interview, with or without a caregiver. Interviews were transcribed verbatim and analysed using Framework analysis.Results: Face-to-face interviews were conducted with 11 patients, and four caregivers (joint interviews). Six themes emerged: (1) Making sense of pain and predicting its course.Participants made a judgement about pain in the context of their underlying illness. (2) Beliefs about analgesics. Participants had concerns about using analgesics. (3) Daytime access.Arrangements were often in place for priority access. (4) Continuity of care. Participants valued personal continuity for scheduled care but not unscheduled care. (5) Barriers and facilitators to help-seeking. The presence of a caregiver particularly facilitated help-seeking; and (5) Satisfaction with OOH care. Structured anticipatory care summaries assisted help-seeking, OOH access, and improved patient satisfaction.Conclusions: Patient’s beliefs and understanding about cancer pain and analgesics should be explored during scheduled care.Barriers to help-seeking should be addressed. A structured palliative care summary can improve the OOH primary care experience.

AB - Background/introduction: Pain is the most frequent complication of cancer. Cancer pain control is often suboptimal despite effective treatments being available. Cancer pain can result in increased healthcare utilization including unscheduled and emergency presentations. The circumstances of out of hours (OOH) primary care use by patients with cancer pain are poorly understood. Cancer pain management may be an appropriate and necessary function of an OOH service. It is also conceivable that some OOH contacts are undesirable and could reflect suboptimal baseline pain management or inadequate anticipatory planning.Research question: What are the circumstances of primary care OOH use by patients who require assistance with cancer pain management?Methods: OOH computerised records in Grampian we researched for Read codes relating to cancer on a weekly basis.Adults who had made contact for help with cancer pain were invited to participate in a semi structured interview, with or without a caregiver. Interviews were transcribed verbatim and analysed using Framework analysis.Results: Face-to-face interviews were conducted with 11 patients, and four caregivers (joint interviews). Six themes emerged: (1) Making sense of pain and predicting its course.Participants made a judgement about pain in the context of their underlying illness. (2) Beliefs about analgesics. Participants had concerns about using analgesics. (3) Daytime access.Arrangements were often in place for priority access. (4) Continuity of care. Participants valued personal continuity for scheduled care but not unscheduled care. (5) Barriers and facilitators to help-seeking. The presence of a caregiver particularly facilitated help-seeking; and (5) Satisfaction with OOH care. Structured anticipatory care summaries assisted help-seeking, OOH access, and improved patient satisfaction.Conclusions: Patient’s beliefs and understanding about cancer pain and analgesics should be explored during scheduled care.Barriers to help-seeking should be addressed. A structured palliative care summary can improve the OOH primary care experience.

KW - Cancer pain

KW - Out of hours primary care

KW - Patient experience

KW - Caregiver experience

U2 - 10.1111/ecc.12373

DO - 10.1111/ecc.12373

M3 - Abstract

VL - 24

SP - 19

JO - European Journal of Cancer Care

JF - European Journal of Cancer Care

SN - 0961-5423

IS - Supplement 2

ER -