title: Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials.
abstract: OBJECTIVE
  Educational interventions are one approach to improving cancer pain management. This review aims to determine whether educational interventions can improve cancer pain management and to characterize components of cancer pain educational interventions.
  
  
  METHODS
  Medline, EMBASE, CINAHL, and Cochrane databases were searched. Systematic reviews that assessed educational interventions to improve cancer pain management were included. Randomized controlled trials (RCTs) were identified from each review. A narrative approach was taken to summarizing the nature and components of interventions.
  
  
  RESULTS
  Eight systematic reviews and 34 randomized controlled trials (RCTs) were reviewed. Interventions targeting patients can achieve small to moderate reductions in pain intensity. Interventions targeting professionals can improve their knowledge but most trials have not assessed for resultant patient benefits. All interventions included at least one of seven core components: improving knowledge about the nature of cancer pain; aiding communication about cancer pain; enhancing pain assessment; improving analgesic prescribing; tackling barriers to analgesic non-adherence; teaching non-pharmacological pain management strategies; and promoting re-assessment.
  
  
  CONCLUSIONS
  Cancer pain educational interventions can improve pain outcomes. They are complex heterogeneous interventions which often contain a combination of active components.
  
  
  CONCLUSIONS
  Suggestions are made to aid the development of future interventions.
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK. Electronic address: rosalindadam@abdn.ac.uk.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Adam
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Bond
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D010043:Outcome and Process Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000523:psychology*; D059408:Pain Management / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
keywords: Cancer; Carer education; Pain; Pain education; Patient education; Professional education