title: Can patient-reported measurements of pain be used to improve cancer pain management? A systematic review and meta-analysis.
abstract: OBJECTIVE
  Cancer pain is a distressing and complex experience. It is feasible that the systematic collection and feedback of patient-reported outcome measurements (PROMs) relating to pain could enhance cancer pain management. We aimed to conduct a systematic review of interventions in which patient-reported pain data were collected and fed back to patients and/or professionals in order to improve cancer pain control.
  
  
  METHODS
  MEDLINE, EMBASE and CINAHL databases were searched for randomised and non-randomised controlled trials in which patient-reported data were collected and fed back with the intention of improving pain management by adult patients or professionals. We conducted a narrative synthesis. We also conducted a meta-analysis of studies reporting pain intensity.
  
  
  RESULTS
  29 reports from 22 trials of 20 interventions were included. PROM measures were used to alert physicians to poorly controlled pain, to target pain education and to link treatment to management algorithms. Few interventions were underpinned by explicit behavioural theories. Interventions were inconsistently applied or infrequently led to changes in treatment. Narrative synthesis suggested that feedback of PROM data tended to increase discussions between patients and professionals about pain and/or symptoms overall. Meta-analysis of 12 studies showed a reduction in average pain intensity in intervention group participants compared with controls (mean difference=-0.59 (95% CI -0.87 to -0.30)).
  
  
  CONCLUSIONS
  Interventions that assess and feedback cancer pain data to patients and/or professionals have so far led to modest reductions in cancer pain intensity. Suggestions are given to inform and enhance future PROM feedback interventions.
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Adam
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Burton
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Bond
authors.affiliation: Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Marijn
authors.initials: M
authors.lastname: de Bruin
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
mesh_terms: D000072716:Cancer Pain / Q000523:psychology / Q000628:therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D059408:Pain Management; D010147:Pain Measurement; D000071066:Patient Reported Outcome Measures; D057566:Self Report
keywords: Cancer; Clinical assessment; PROM; Pain; self-report