Measuring pain perceptions and medication taking behavior at the end of life: a pilot study.
BACKGROUND
Understanding why some patients with terminal illness are reluctant to take sufficient medication to control pain is critical to effective pain management.


OBJECTIVE
As a first step toward exploring the pain medication-taking behavior of palliative care patients, this pilot study tested a survey regarding pain medication adherence, medication beliefs, and quality of life (QoL).


METHODS
Convenience sample; survey.


METHODS
Six patients receiving inpatient Palliative Care consultations at an academic medical center answered questions about their outpatient pain medication-taking behavior.


METHODS
Medication Adherence Report Scale (MARS), Beliefs about Medications Questionnaire (BMQ), Brief Pain Inventory (BPI), closed-response items from a pain medication adherence study in terminally ill patients, the McGill Quality of Life Questionnaire (McGill), and demographic items.


RESULTS
The battery of questionnaires took approximately 53 minutes; five of six participants were able to complete all items. Respondents reported moderate to severe pain (mean 4.3/10 for pain on average; 7/10 for worst pain in past 24 hours), and excellent medication adherence. When asked how much relief was provided by pain therapies, respondents reported a mean 73% (range 50-100%) relief. They expressed little concern about addiction, but more concern about medication-induced nausea and constipation. Overall QoL was good (mean 6.8/10, range 5-10, higher score better), with notably high scores in existential and support domains.


CONCLUSIONS
Inpatients receiving palliative care consultation were able to complete interviewer-administered questionnaires regarding their pain perceptions, medications, and QoL. Further studies using these instruments are feasible and could inform shared decision making about pain management.
Physician and Director, Colorado REAP in Care Coordination Eastern Colorado Health Care System/Denver VAMC.
Evelyn
E
Hutt
Research Nurse Scientist, University of Colorado Hospital Associate Professor, University of Colorado College of Nursing, Anschutz Medical Campus regina.fink@uchealth.org.
Regina M
RM
Fink
Associate Professor, University of Colorado College of Nursing, Anschutz Medical Campus.
Paula
P
Nelson-Marten
Associate Professor, University of Colorado College of Nursing, Anschutz Medical Campus.
Jacqueline
J
Jones
Gordon Meiklejohn Endowed Professor of Medicine Division Head, Division of General Internal Medicine University of Colorado School of Medicine.
Jean S
JS
Kutner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003120:Colorado; D064420:Drug-Related Side Effects and Adverse Reactions / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D059408:Pain Management / Q000523:psychology*; D058748:Pain Perception; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*; D016903:Drug Monitoring
medication adherence; pain perceptions; palliative care; pilot study; quality of life; survey design