Pain education for underserved minority cancer patients: a randomized controlled trial.
OBJECTIVE
Previous studies found that African American and Hispanic cancer patients are at risk for undertreatment of pain. We evaluated the efficacy of a pain education intervention for underserved minority patients.


METHODS
Ninety-seven underserved African American and Hispanic outpatients with cancer-related pain were enrolled onto a randomized clinical trial of pain management education. The patients in the education group received a culture-specific video and booklet on pain management. The control group received a video and booklet on nutrition. A research nurse met with each patient to review the materials. We measured changes in pain intensity and pain-related interference 2 to 10 weeks after the intervention, as well as changes in quality of life, perceived pain control, functional status, analgesics, and physician pain assessments.


RESULTS
Physicians underestimated baseline pain intensity and provided inadequate analgesics for more than 50% of the sample. Although the ratings for pain intensity and pain interference decreased over time for both groups, there was no statistically significant difference between groups. Pain education did not affect quality of life, perceived pain control, or functional status. African American patients in the education but not the control group reported a significant decrease in pain worst ratings from baseline to first follow-up (P < .01), although this decrease was not maintained at subsequent assessments.


CONCLUSIONS
Brief education had limited impact on pain outcomes for underserved minority patients, suggesting that more intensive education for patients and interventions for physicians are needed.
Anderson
Karen O
KO
Department of Symptom Research, The University of Texas M.D. Anderson Cancer Center, 1100 Holcombe Blvd, Box 221, Houston, TX 77030, USA. koanderso@mdanderson.org
Mendoza
Tito R
TR
Payne
Richard
R
Valero
Vicente
V
Palos
Guadalupe R
GR
Nazario
Arlene
A
Richman
Stephen P
SP
Hurley
Judith
J
Gning
Ibrahima
I
Lynch
Garrett R
GR
Kalish
Dorianne
D
Cleeland
Charles S
CS
D001741:Black or African American; D000700:Analgesics / Q000627:therapeutic use; D003466:Cultural Characteristics; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009747:Nutritional Physiological Phenomena; D010146:Pain / Q000188:drug therapy; D059408:Pain Management; D010353:Patient Education as Topic; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome
D000700:Analgesics