Pain management for elderly patients with cancer at home

Pain is an important problem for patients with cancer and is particularly important for elderly patients with cancer and their family care givers. Increasingly, cancer is managed on an outpatient basis with pain management responsibility assumed by the family at home. This study evaluated a structured pain education program that included three components: basic pain management principles and assessment, pharmacologic interventions, and nondrug treatments.

The pain education intervention was implemented across three home visits with two points of follow-up evaluation. Outcomes of the 66 elderly patients with cancer completing the educational program included measures of quality of life, patient knowledge and attitudes regarding pain, and use of a self-care log to document drug and nondrug interventions and their effectiveness.

Repeated measurement analysis was used to evaluate the outcomes of the three-part education intervention. Results indicate an improvement in knowledge and attitudes regarding pain as well as the use of drug and nondrug interventions. Outcomes of the quality of life instrument suggest significant effect of pain on all aspects of quality of life, including physical well being, psychological well being, social concerns, and spiritual well being.

The investigators concluded that the pain education intervention provided important support to elderly patients with cancer and family members at home. Structured pain education based on an evolving science of pain relief should become a part of the standard health care for pain management. Improved pain management includes quality of life for the elderly patient with cancer as well as for family care givers.