A study featuring Carevive technology has been published in JADPRO. Led by Jeannine Brant and Debra Wujcik this research study explores the use of shared decision-making to evaluate its impact on cancer pain management. “Our research shows shared decision making incorporated into discussions about pain management can facilitate improved outcomes including less breakthrough pain episodes,” stated Wujcik.
Background
Pain is a significant problem in patients with cancer. Breakthrough cancer pain contributes to the pain experience, but it is often under-assessed and underrecognized. Shared decision-making (SDM), where patient preferences, goals, and concerns are discussed and integrated into a shared decision, can potentially foster earlier identification of pain, including breakthrough cancer pain, and improve pain management.
Objectives
To explore the use of SDM to evaluate its impact on cancer pain management. Methods: This prospective, multisite study engaged patients with advanced cancer to explore the use of SDM in managing cancer pain using a digital platform with an expanded pain assessment. Decision preferences were noted and incorporated into care. Outcomes included pain and patient-perceived pain care quality.
Results
51 patients with advanced cancer enrolled in the study. The mean pain score was 5 out of 10 throughout the three study time points. 88% of patients experienced breakthrough cancer pain of severe intensity at baseline and approximately 70% at visits two and three. The majority of breakthrough cancer pain episodes lasted longer than 30 minutes. The majority (86%) of participating patients desired shared decision-making or patient-driven decision-making. Most patients expressed satisfaction with the level of shared decision-making in managing their cancer pain. Breakthrough cancer pain remained significant for most patients.
Conclusions
SDM incorporated into pain discussions has the potential to improve pain outcomes, but significant challenges remain in managing breakthrough cancer pain.
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