DULUTH, Minn-Effective strategies to improve cancer pain management
in the community may be elusive, but researchers from the Minnesota
Cancer Pain Project, led by Thomas E. Elliott, MD, believe they
are on the right track with an intervention program that combines
education of community opinion leaders with community outreach
To evaluate the program, the researchers randomly assigned three
pairs of matched communities to receive either intervention or
no intervention, Project Director Karen Johnson, MPH, of the Duluth
Clinic, said at her Congress poster presentation.
Opinion leader educators (physicians, nurses, pharmacists, social
workers, and clergy) from the intervention areas participated
in a 2-day minifellowship that included lectures, clinical and
hospice rounds, and preceptorships; they then returned to their
communities to set up a task force of other educators, to diffuse
the message and train their peers. This strategy was reinforced
with community outreach education programs.
The results showed positive trends in the intervention communities
toward reduced pain prevalence and improvement in physicians'
and nurses' knowledge and attitude scores, but none reached significance.
Although the quantitative data were not statistically significant,
Ms. Johnson believes the qualitative data, derived from surveys
of task force members, suggest that the intervention produced
"a much larger shift in behaviors than could be demonstrated
with the instruments that we used."
The task force members reported that previously unavailable pain
assessment tools were now being used, and pain protocols were
being instituted. "We believe this type of intervention,
trying to change patient pain levels by educating the people who
treat them, should prove effective in future intervention studies,"
Ms. Johnson said.