NEW ORLEANSAn educational intervention for both patients and
health care professionals led to significant improvements in pain
control at the RUSH Cancer Institute of RUSH-Presbyterian-St.
Lukes Medical Center, Chicago. David Frame, PharmD, reported
the results at the 36th Annual Meeting of the American
Society of Clinical Oncology (ASCO).
During a 2-month baseline period, all patients admitted to the
oncology unit were interviewed by a team of pharmacists regarding
their pain (rated on a scale of 0 to 10) and their satisfaction with
their pain control during the first 3 days of their stay.
During this same period, nurses, pharmacists, oncologists, and
internal medicine residents completed knowledge and attitude surveys
regarding pain and its treatment.
In the second phase of the study (quality improvement intervention),
education regarding pain was provided to the health care
professionals through the use of inservices, decision trees,
reference cards on pain assessment and treatment, and adding pain
scores as a fifth vital sign to the patient flow sheet.
Patients were educated about pain control through posters, handouts,
and verbal education.
After the intervention period, patients and health care professionals
were again queried as in the baseline period.
The results showed that after the intervention:
Nurses documentation of pain in the patients charts
increased significantly, and physicians documentation improved.
Mean patient pain scores decreased significantly by day 3 of
hospital admission (see Figure).
Fewer patients had moderate-to-severe pain by day 3 of
Patient satisfaction with their pain relief increased
significantly. After the intervention, 82% said they were very
satisfied with their pain relief, compared with 37% before the intervention.
Use of opioids in pain treatment increased.
Patients attitudes toward pain medications improved.
They reported decreased fear of addiction and decreased fear of
tolerance, and patients were more likely to ask for pain medication.
These results suggest that implementing efforts to
increase awareness of pain management to health care providers and
patients results in a significant improvement in pain control,
Dr. Frame said.
However, Dr. Frame pointed out, the overall pain scores still
reflect that continued intervention is necessary. Based on the
study results, the center has instituted hospital-wide efforts to
continue to improve pain control.