Establishment of Personalized Pain Goals in Oncology Patients to Improve Care and Decrease Costs.

Area of Science:

• Oncology
• Pain Management
• Health Services Research

Background:

• Cancer-related pain significantly impacts patient quality of life and survival.
• Opioid analgesics are commonly used, but patient-reported data on pain, medication, and satisfaction are often limited.
• Effective pain management strategies are crucial in oncology care.

Purpose of the Study:

• To assess the impact of a quality improvement intervention on pain management in an outpatient oncology setting.
• To evaluate changes in the documentation of personalized pain goals (PPGs) and opioid prescribing patterns.
• To determine if the intervention improved patient outcomes and reduced treatment costs.

Main Methods:

• Analysis of 18 months of electronic medical record data from outpatient oncology clinics.
• Implementation of a pain intervention including patient handouts, clinician education on opioid cost-effectiveness, and a nursing protocol for PPG documentation.
• Comparison of pain levels, PPG documentation rates, and opioid prescription patterns pre- and post-intervention.

Main Results:

• Moderate to severe pain was reported in approximately 15% of patient encounters.
• A significant increase in documented PPGs was observed, from 16% to 71% (P < .001).
• Prescriptions for high-cost long-acting opioids decreased from 45% to 33% (P = .005), with PPGs achieved in 84% of patients.

Conclusions:

• The quality improvement intervention effectively enhanced PPG documentation and reduced the use of expensive opioid medications.
• Simple quality improvement strategies, including patient-centered goal setting and clinician education, can optimize cancer pain management.
• Implementing these methods can lead to improved patient outcomes and decreased healthcare expenditures in oncology clinics.