Individualized patient education and coaching to improve pain control among cancer outpatients.
OBJECTIVE
An estimated 42% of cancer patients suffer from poorly controlled pain, in part because of patient-related barriers to pain control. The objective of this study was to evaluate the effect of an individualized education and coaching intervention on pain outcomes and pain-related knowledge among outpatients with cancer-related pain.


METHODS
English-speaking cancer patients (18 to 75 years old) with moderate pain over the past 2 weeks were randomly assigned to the experimental (n = 34) or control group (n = 33). Experimental patients received a 20-minute individualized education and coaching session to increase knowledge of pain self-management, to redress personal misconceptions about pain treatment, and to rehearse an individually scripted patient-physician dialog about pain control. The control group received standardized instruction on controlling pain. Data on average pain, functional impairment as a result of pain, pain frequency, and pain-related knowledge were collected at enrollment and 2-week follow-up.


RESULTS
At baseline, there were no significant differences between experimental and control groups in terms of average pain, functional impairment as a result of pain, pain frequency, or pain-related knowledge. At follow-up, average pain severity improved significantly more among experimental group patients than among control patients (P =.014). The intervention had no statistically significant impact on functional impairment as a result of pain, pain frequency, or pain-related knowledge.


CONCLUSIONS
Compared with provision of standard educational materials and counseling, a brief individualized education and coaching intervention for outpatients with cancer-related pain was associated with improvement in average pain levels. Larger studies are needed to validate these effects and elucidate their mechanisms.
Oliver
J W
JW
Department of Medicine and Center for Health Services Research in Primary Care, University of California, Davis 95817, USA.
Kravitz
R L
RL
Kaplan
S H
SH
Meyers
F J
FJ
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000523:psychology; D059408:Pain Management; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D012648:Self Care; D016896:Treatment Outcome