A systematic review of health care interventions for pain in patients with advanced cancer

Am J Hosp Palliat Care. 2014 Feb;31(1):79-86. doi: 10.1177/1049909113476129. Epub 2013 Feb 12.

Abstract

Purpose: Poorly controlled pain is common in advanced cancer. The objective of this article was to synthesize the evidence on the effectiveness of pain-focused interventions in this population.

Methods: We searched MEDLINE, CINAHL, PsycINFO, Cochrane, and DARE from 2000 through December 2011. We included prospective, controlled health care intervention studies in advanced cancer populations, focusing on pain.

Results: Nineteen studies met the inclusion criteria; most focused on nurse-led patient-centered interventions. In all, 9 (47%) of the 19 studies found a significant effect on pain. The most common intervention type was patient/caregiver education, in 17 (89%) of 19 studies, 7 of which demonstrated a significant decrease in pain.

Conclusions: We found moderate strength of evidence that pain in advanced cancer can be improved using health care interventions, particularly nurse-led patient-centered interventions.

Keywords: advanced cancer; end of life; health care interventions; pain; quality improvement; systematic review.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Clinical Trials as Topic
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Neoplasms / complications*
  • Pain / etiology*
  • Pain Management / methods*
  • Palliative Care / methods*
  • Patient Education as Topic
  • Patient Satisfaction
  • Severity of Illness Index