Cancer patients’ pain eased by simple bedside chart

Cancer patients’ pain eased by simple bedside chart

Patients with cancer could benefit from a simple bedside chart system to manage their pain, a study suggests.

The new approach reduces pain levels compared with conventional care, the research with patients shows.

Pain affects half of all people with cancer and an estimated 80 per cent of those with advanced cancer, causing both physical and emotional impact on patients.

Researchers at the University of Edinburgh worked with doctors to develop the Edinburgh Pain Assessment and management Tool (EPAT) – a pen and paper chart which medical staff use to regularly record pain levels in a simple traffic light system.

Amber or red pain levels – indicating moderate or severe pain – prompts doctors to review medications and side effects and monitor pain more closely.

The trial looked at pain levels in almost 2000 cancer patients over five days, following admission to regional cancer centres.

Patients whose care included use of the chart reported less pain during this time, compared with patients with standard care, who did not show an improvement.

Importantly, use of the chart was not linked to higher medicine doses. Authors suggest that it works by encouraging doctors to ask the right questions and reflect on pain medications and side effects more frequently, before patients reach a crisis point.

Researchers say the system is a simple way to put pain management at the forefront of routine care, but caution that more studies are needed to understand how it could work longer term.

The study was published in the Journal of Clinical Oncology and was funded by Cancer Research UK.

Professor Marie Fallon, of the Palliative and Supportive Care Group at the University of Edinburgh, said: “These exciting findings show the important benefits of influencing doctors’ behaviours, rather than looking for more complex and expensive interventions. These findings are a positive step towards reducing the burden of pain for patients and making them as comfortable as possible at all stages of cancer.”

Martin Ledwick, Head Information Nurse at Cancer Research UK, said: “In most cases it should be possible for cancer pain to be controlled if it is assessed and managed effectively. Any work that encourages medical teams to assess and monitor pain more carefully to help this happen has to be a good thing for patients.”

Source: University of Edinburgh

Reference: Marie Fallon, Jane Walker, Lesley Colvin, Aryelly Rodriguez, Gordon Murray, Michael Sharpe. Pain Management in Cancer Center Inpatients: A Cluster Randomized Trial to Evaluate a Systematic Integrated Approach—The Edinburgh Pain Assessment and Management ToolJournal of Clinical Oncology, 2018; JCO.2017.76.182 DOI: 10.1200/JCO.2017.76.1825

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