Improving Patient-reported Pain During Radiotherapy Through Nurse Involvement and Patient Education

Pain management during radiotherapy helps assess quality of care. By establishing an intervention to address pain during on-treatment visits (OTVs), we aim to lower patient-reported pain scores.

A total of 171 patients were included in the analysis: 58 were retrospectively reviewed to provide a control and 113 were prospectively enrolled and evaluated after the intervention. The intervention included (1) a pain management in-service performed with the resident physician and nurses, (2) distribution of pain management educational materials, and (3) nurse consultation for patients with a pain score ≥5 within 2 days of the in-service. Study aims were to reduce the number of pain scores ≥5 by 30% and increase the number of pain scores documented during every OTV to >90%.

Median patient age was 65 years. Before the intervention, the average DVPRS score at initial consultation was 2 (range, 0 to 9) and 98% of patients had scores documented during OTVs. Overall, 26% (44/171) of OTV scores measured ≥5. Following the intervention, average DVPRS score at initial consultation was 2 (range, 0 to 10) and 99% of scores were documented during OTVs. About 14% (49/341) of patient-reported scores were ≥5, representing an ~50% relative reduction (P=0.023). The number of patients with 2+ pain scores ≥5 was reduced from 21% (12/58) before the intervention to 11% (12/109) after the intervention (P=0.1068).

Involving nursing staff in the education and follow-up of patients with uncontrolled pain during radiotherapy led to an ~50% relative reduction in patient-reported DVPRS scores of 5+ during weekly OTVs.