title: Automated pain intervention for underserved minority women with breast cancer.
abstract: BACKGROUND
  Minority patients with breast cancer are at risk for undertreatment of cancer-related pain. The authors evaluated the feasibility and efficacy of an automated pain intervention for improving pain and symptom management of underserved African American and Latina women with breast cancer.
  
  
  METHODS
  Sixty low-income African American and Latina women with breast cancer and cancer-related pain were enrolled in a pilot study of an automated, telephone-based, interactive voice response (IVR) intervention. Women in the intervention group were called twice weekly by the IVR system and asked to rate the intensity of their pain and other symptoms. The patients' oncologists received e-mail alerts if the reported symptoms were moderate to severe. The patients also reported barriers to pain management and received education regarding any reported obstacles.
  
  
  RESULTS
  The proportion of women in both groups reporting moderate to severe pain decreased during the study, but the decrease was significantly greater for the intervention group. The IVR intervention also was associated with improvements in other cancer-related symptoms, including sleep disturbance and drowsiness. Although patient adherence to the IVR call schedule was good, the oncologists who were treating the patients rated the intervention as only somewhat useful for improving symptom management.
  
  
  CONCLUSIONS
  The IVR intervention reduced pain and symptom severity for underserved minority women with breast cancer. Additional research on technological approaches to symptom management is needed.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Karen O
authors.initials: KO
authors.lastname: Anderson
authors.affiliation: Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Guadalupe R
authors.initials: GR
authors.lastname: Palos
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Liao
authors.affiliation: Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Araceli
authors.initials: A
authors.lastname: Garcia-Gonzalez
authors.affiliation: Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Alyssa G
authors.initials: AG
authors.lastname: Rieber
authors.affiliation: Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: L Arlene
authors.initials: LA
authors.lastname: Nazario
authors.affiliation: Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.affiliation: London Regional Cancer Program, London Health Sciences Center, London, Ontario, Canada.
authors.forename: Karin M
authors.initials: KM
authors.lastname: Hahn
authors.affiliation: Department of Psychiatry and Behavioral Sciences, The University of Texas Health Sciences Center, Houston, Texas.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Person
authors.affiliation: Duke Institute on Care at the End of Life, Duke University Divinity School, Durham, North Carolina.
authors.forename: Richard
authors.initials: R
authors.lastname: Payne
mesh_terms: D001741:Black or African American; D001331:Automation / Q000379:methods; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000208:ethnology* / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011203:Poverty; D017216:Telemedicine / Q000379:methods; D035862:Vulnerable Populations
keywords: assessment; breast cancer; minority groups; pain; symptoms