B R Ferrell1, G Juarez, T Borneman. 1. Nursing Research and Education Department, City of Hope National Medical Center, Duarte, CA, USA. bferrell@coh.org
Abstract
PURPOSE/ OBJECTIVES: To describe current use of routine analgesics in home care and the treatment of breakthrough pain. DESIGN: Descriptive, companion study. SETTING: Homecare agencies in southern California. SAMPLE: Convenience sample of 369 patients with cancer participating in a pain-education study. METHODS: Data regarding breakthrough pain were derived from the homecare medical records and patient interviews. MAIN RESEARCH VARIABLES: Analgesic medications prescribed and used for treatment of routine and breakthrough cancer pain. FINDINGS: Results demonstrate discrepancy between recommended pain management in clinical practice guidelines and the actual practice of pain management at home. Deficiencies were found in medications prescribed as well as in actual use by patients. CONCLUSIONS: Optimum relief of cancer pain is contingent on adequate treatment of routine and breakthrough pain, including greater use of recommended analgesics in adequate doses and clinical care consistent with clinical practice guidelines. IMPLICATIONS FOR NURSING PRACTICE: Breakthrough pain is a common problem affecting the quality of life of patients with cancer. Improved management of breakthrough pain is contingent on accurate pain assessment, optimum use of analgesics, and patient education. Nurses should address the important topic of breakthrough pain as new analgesic drugs and methods of delivery become available.
PURPOSE/ OBJECTIVES: To describe current use of routine analgesics in home care and the treatment of breakthrough pain. DESIGN: Descriptive, companion study. SETTING: Homecare agencies in southern California. SAMPLE: Convenience sample of 369 patients with cancer participating in a pain-education study. METHODS: Data regarding breakthrough pain were derived from the homecare medical records and patient interviews. MAIN RESEARCH VARIABLES: Analgesic medications prescribed and used for treatment of routine and breakthrough cancer pain. FINDINGS: Results demonstrate discrepancy between recommended pain management in clinical practice guidelines and the actual practice of pain management at home. Deficiencies were found in medications prescribed as well as in actual use by patients. CONCLUSIONS: Optimum relief of cancer pain is contingent on adequate treatment of routine and breakthrough pain, including greater use of recommended analgesics in adequate doses and clinical care consistent with clinical practice guidelines. IMPLICATIONS FOR NURSING PRACTICE: Breakthrough pain is a common problem affecting the quality of life of patients with cancer. Improved management of breakthrough pain is contingent on accurate pain assessment, optimum use of analgesics, and patient education. Nurses should address the important topic of breakthrough pain as new analgesic drugs and methods of delivery become available.
Authors: Sara Sanders; Keela A Herr; Perry G Fine; Catherine Fiala; Xiongwen Tang; Chris Forcucci Journal: J Pain Symptom Manage Date: 2012-07-26 Impact factor: 3.612