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Testing the Implementation of a Pain Self-management Support Intervention for Oncology Patients in Clinical Practice: A Randomized Controlled Pilot Study (ANtiPain)

Koller, Antje PhD, RN; Gaertner, Jan MD; De Geest, Sabina PhD, RN, FAAN; Hasemann, Monika; Becker, Gerhild MD, MTh, MSc
doi: 10.1097/NCC.0000000000000502
Article: PDF Only

Background:

In oncology, pain control is a persistent problem. Significant barriers to cancer pain management are patient related. Pain self-management support interventions have shown to reduce pain intensity and patient-related barriers. Comparative effectiveness research is a suitable approach to test whether effects are sustained in clinical practice.

Objective:

In this pilot randomized controlled trial, the implementation of the ANtiPain intervention into clinical practice was tested to assess the effects on pain intensity, function-related outcomes, self-efficacy, and patient-related barriers to pain management to prepare a larger effectiveness trial.

Methods:

Within 14 months, 39 adult oncology patients with pain scores of 3 or higher on a 10-point numeric rating scale were recruited in an academic comprehensive cancer center in Southern Germany. Patients in the control group (n=19) received standard care. Patients in the intervention group (n=20) received ANtiPain, a cancer pain self-management support intervention based on 3 key strategies: provision of information, skill building, and nurse coaching. An intervention session was performed in-hospital. After discharge, follow-up was provided via telephone calls. Data were collected at baseline and 1 and 6 weeks after discharge. Effect sizes were calculated for all outcomes.

Results:

Large effects were found for activity hindrance (Cohen d=0.90), barriers (d=0.91), and self-efficacy (d=0.90). Small to moderate effects were found for average and worst pain (Cohen d=0.17-0.45).

Conclusions:

Key findings of this study involved function-related outcomes and self-efficacy.

Implications for Practice:

Because these outcomes are particularly meaningful for patients, the integration of ANtiPain to routine clinical practice may be substantial. A larger study will be based on these findings.

This research was funded through the program “Development and coordination of health services research in Baden-Württemberg” (Ausbau und Koordination der Versorgungsforschung in Baden-Württemberg), especially the “Junior researcher academy related to health services research” (Nachwuchsakademie Versorgungsforschung). In addition, funding was received by the INDICAR Postdoctoral Fellowship Programme, which is cofunded by the EU Frameworkprogramme 7 (FP7) Marie Curie Actions (grant agreement 609431).

The authors have no conflicts of interest to disclose.

Correspondence: Antje Koller, PhD, RN, Institute of Nursing Science, Faculty of Social Sciences, University of Vienna, Alser Str. 23/12, 1080 Vienna (antje.koller@univie.ac.at).

Accepted for publication February 15, 2017.

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