Work as a Team
Patient-centered care should be utilized when working with individual patients to complete a pain assessment. Each clinician should engage with patients individually and create a plan that best meets the patient’s needs using multimodal methods. These methods should include both opioid and nonopioid treatments.12 In addition, the patient should be encouraged to actively engage in the process. Engaged patients have been shown to have better pain outcomes.13
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For our patients with cancer, using the same pain scale, completing a comprehensive pain assessment at each visit, and actively listening can elicit the best response.
Acknowledging that cancer pain is still underresearched and undertreated is the beginning of how we can handle pain in this changing climate. Providing cancer patients with diverse methods to become active participants in their care by educating them on what to expect can be an initial step, along with creating partnerships for managing pain through patient-centered care.
References
1. Tefera L, Lehrman WG, Conway P. Measurement of the patient experience: clarifying facts, myths, and approaches. JAMA. 2016;315(20):2167-2168.
2. Prescription opioid Overdose data. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugoverdose/data/overdose.html. Accessed May 1, 2017.
3. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths — United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2016;16(50-51):1378-1382.
4. Bruera E, Paice JA. Cancer pain management: safe and effective use of opioids. Am Soc Clin Oncol Educ Book. 2015:e593-e599.
5. Reich DL, Porter C, Levin MA, et al. Data-driven interdisciplinary interventions to improve inpatient pain management. Am J Med Qual. 2013;28(3):187-195.
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7. Lemay CA, Ayers D, Franklin PD. Effective pain information pre-operatively is associated with improved functional gain after total joint replacement. Poster presented at: UMass Center for Clinical and Translational Science 6th Annual Research Retreat; May 20, 2016; Worcester, MA.
8. Smith MY, DuHamel KN, Egert J, Winkel G. Impact of a brief intervention on patient communication and barriers to pain management: results from a randomized controlled trial. Patient Educ Couns. 2010;81(1):79-86.
9. McCaffery M. Clinical Nursing: Nursing Practice Theories Related to Cognition, Bodily Pain, and Man-environment Interactions. Oakland, CA: Regents of the University of California, 1968.
10. Cronje RJ, Williamson OD. Is pain ever “normal”? Clinical J Pain. 2006;22(8):692-699.
11. Zgierska A, Miller M, Rabago D. Patient satisfaction, prescription drug abuse, and potential unintended consequences. JAMA. 2012;307(13):1377-1378.
12. Pasero C, McCaffery M, eds. Pain Assessment and Pharmacologic Management. St Louis, MO: Mosby; 2011.
13. Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Aff (Millwood). 2013;32(2):250-258.
