Examining the Effectiveness of Opiate Use in Cancer Pain Management: Variation Across Outpatient Oncology Clinic Settings

2.50
Hdl Handle:
http://hdl.handle.net/10755/165484
Category:
Abstract
Type:
Presentation
Title:
Examining the Effectiveness of Opiate Use in Cancer Pain Management: Variation Across Outpatient Oncology Clinic Settings
Author(s):
Thomas, M.; Hwang, S.; Annis, D.; Fahey, K.; Elliott, J.; Douglas, M.
Author Details:
M. Thomas, VA Palo Alto Health Care System, Palo Alto, California, USA; S. Hwang; D. Annis; K. Fahey; J. Elliott; M. Douglas
Abstract:
Despite continued emphasis, effective pain management (PM) remains difficult to achieve. One potential barrier may be inadequate individualization of PM; i.e., approaches to PM may be setting-specific, rather than patient-specific. Purpose: The purpose of this pilot study was to compare the amount of pain medication prescribed at three VA oncology clinics and to assess its impact on patients' pain intensity ratings, satisfaction with PM, and specific quality of life parameters. Theoretical/Scientific Framework: Ahles’ multidimensional nature of cancer pain served as the conceptual framework for this study. Methods: The Brief Pain Inventory was used to measure the dependent variables of pain severity, pain relief, and impact of pain on various dimensions of quality of life (e.g., general activity, sleep, enjoyment with life); this instrument has established reliability and validity. Medications, prescribed and taken, were recorded and converted into morphine equivalents (MEQ) using AHCPR guidelines. Data Analysis: The dependent variables were examined using a one-way ANOVA. For those variables demonstrating a statistically significant difference in mean scores, a pair-wise contrast analysis was performed using the Bonferroni or Dunnett T3 method as appropriate. Findings and Implications: 141 adults (96% male) with a variety of cancer types who reported having cancer pain participated in this study. The mean amount of medication prescribed for patients at Clinic A (188 mg MEQ; s.d. 187 mg) was significantly greater (p < .001) than that at Clinic B or C (80 mg MEQ; s.d. 102 mg; 58 mg MEQ; s.d. 78 mg, respectively). Similar findings were realized when comparing the amount of opiates reported as actually taken by the patients, albeit less than was prescribed. Despite the great difference in amount of opiates used by those at Clinic A, there was no significant difference in patients’ pain intensity ratings, amount of pain relief achieved, or in ratings of impact of pain on specific quality of life parameters across the three clinic settings. While liberal use of opiates is often considered an integral component of effective PM, data from this study suggest that cancer pain can persist despite liberal opiate use. Additional approaches may be necessary in conjunction with opiate use if PM is to be truly effective.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
29th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Anaheim, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleExamining the Effectiveness of Opiate Use in Cancer Pain Management: Variation Across Outpatient Oncology Clinic Settingsen_GB
dc.contributor.authorThomas, M.en_US
dc.contributor.authorHwang, S.en_US
dc.contributor.authorAnnis, D.en_US
dc.contributor.authorFahey, K.en_US
dc.contributor.authorElliott, J.en_US
dc.contributor.authorDouglas, M.en_US
dc.author.detailsM. Thomas, VA Palo Alto Health Care System, Palo Alto, California, USA; S. Hwang; D. Annis; K. Fahey; J. Elliott; M. Douglasen_US
dc.identifier.urihttp://hdl.handle.net/10755/165484-
dc.description.abstractDespite continued emphasis, effective pain management (PM) remains difficult to achieve. One potential barrier may be inadequate individualization of PM; i.e., approaches to PM may be setting-specific, rather than patient-specific. Purpose: The purpose of this pilot study was to compare the amount of pain medication prescribed at three VA oncology clinics and to assess its impact on patients' pain intensity ratings, satisfaction with PM, and specific quality of life parameters. Theoretical/Scientific Framework: Ahles&rsquo; multidimensional nature of cancer pain served as the conceptual framework for this study. Methods: The Brief Pain Inventory was used to measure the dependent variables of pain severity, pain relief, and impact of pain on various dimensions of quality of life (e.g., general activity, sleep, enjoyment with life); this instrument has established reliability and validity. Medications, prescribed and taken, were recorded and converted into morphine equivalents (MEQ) using AHCPR guidelines. Data Analysis: The dependent variables were examined using a one-way ANOVA. For those variables demonstrating a statistically significant difference in mean scores, a pair-wise contrast analysis was performed using the Bonferroni or Dunnett T3 method as appropriate. Findings and Implications: 141 adults (96% male) with a variety of cancer types who reported having cancer pain participated in this study. The mean amount of medication prescribed for patients at Clinic A (188 mg MEQ; s.d. 187 mg) was significantly greater (p &lt; .001) than that at Clinic B or C (80 mg MEQ; s.d. 102 mg; 58 mg MEQ; s.d. 78 mg, respectively). Similar findings were realized when comparing the amount of opiates reported as actually taken by the patients, albeit less than was prescribed. Despite the great difference in amount of opiates used by those at Clinic A, there was no significant difference in patients&rsquo; pain intensity ratings, amount of pain relief achieved, or in ratings of impact of pain on specific quality of life parameters across the three clinic settings. While liberal use of opiates is often considered an integral component of effective PM, data from this study suggest that cancer pain can persist despite liberal opiate use. Additional approaches may be necessary in conjunction with opiate use if PM is to be truly effective.en_GB
dc.date.available2011-10-27T12:19:22Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:19:22Z-
dc.conference.date2004en_US
dc.conference.name29th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationAnaheim, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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