Influence of patient coaching on analgesic treatment adjustment: secondary analysis of a randomized controlled trial

Journal of Pain and Symptom Management
Richard L KravitzPeter Franks

Abstract

For patients with cancer-related pain and their physicians, routine oncology visits are an opportunity to adjust the analgesic regimen and secure better pain control. However, treatment intensification occurs haphazardly in practice. To estimate the effect of patient-centered tailored education and coaching (TEC) on the likelihood of analgesic treatment adjustment during oncology visits, and in turn, the influence of treatment adjustment on subsequent cancer pain control, we studied patients enrolled in a randomized trial of TEC. Just before a scheduled oncology visit, 258 patients with at least moderate baseline pain received TEC or control; just after the same visit, they reported on whether the physician recommended a new pain medicine or a change in dose of an existing medicine. Pain severity and pain-related impairment were measured two, six, and 12 weeks later. Patients assigned to TEC were more likely than controls to report a change in the analgesic treatment regimen (60% vs. 36%, P<0.01); significant effects persisted after adjustment for baseline pain, study site, and physician (adjusted odds ratio 2.61, 95% confidence interval 1.55, 4.40, P<0.01). In a mixed-effects repeated measures regression, analgesic change (but...Continue Reading

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Citations

Apr 2, 2014·Psycho-oncology·Richard L StreetRichard L Kravitz
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May 12, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Caroline MaindetAntoine Lemaire

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