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 programs.
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.
