Improving the management of pain from advanced cancer in the community: study protocol for a pragmatic multicentre randomised controlled trial.

Abstract:

INTRODUCTION:For patients with advanced cancer, research shows that pain is frequent, burdensome and undertreated. Evidence-based approaches to support cancer pain management have been developed but have not been implemented within the context of the UK National Health Service. This protocol is for a pragmatic multicentre randomised controlled trial (RCT) to assess feasibility, acceptability, effectiveness and cost-effectiveness for a multicomponent intervention for pain management in patients with advanced cancer. METHODS AND ANALYSIS:This trial will assess the feasibility of implementation and uptake of evidence-based interventions, developed and piloted as part of the Improving the Management of Pain from Advanced Cancer in the Community Programme grant, into routine clinical practice and determine whether there are potential differences with respect to patient-rated pain, patient pain knowledge and experience, healthcare use, quality of life and cost-effectiveness. 160 patients will receive either the intervention (usual care plus supported self-management) delivered within the oncology clinic and palliative care services by locally assigned community palliative care nurses, consisting of a self-management educational intervention and eHealth intervention for routine pain assessment and monitoring; or usual care. The primary outcomes are to assess implementation and uptake of the interventions, and differences in terms of pain severity. Secondary outcomes include pain interference, participant pain knowledge and experience, and cost-effectiveness. Outcome assessment will be blinded and patient-reported outcome measures collected via post at 6 and 12 weeks following randomisation. ETHICS AND DISSEMINATION:This RCT has the potential to significantly influence National Health Service delivery to community-based patients with pain from advanced cancer. We aim to provide definitive evidence of whether two simple interventions delivered by community palliative care nurse in palliative care that support-self-management are clinically effective and cost-effective additions to standard community palliative care. TRIAL REGISTRATION NUMBER:ISRCTN18281271; Pre-results.

journal_name

BMJ Open

journal_title

BMJ open

authors

Allsop MJ,Wright-Hughes A,Black K,Hartley S,Fletcher M,Ziegler LE,Bewick BM,Meads D,Hughes ND,Closs SJ,Hulme C,Taylor S,Flemming K,Hackett J,O'Dwyer JL,Brown JM,Bennett MI

doi

10.1136/bmjopen-2018-021965

subject

Has Abstract

pub_date

2018-03-22 00:00:00

pages

e021965

issue

3

issn

2044-6055

pii

bmjopen-2018-021965

journal_volume

8

pub_type

杂志文章,多中心研究

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