Apr. 18, 2001 (SACRAMENTO, Calif.) — Cancer patients who received coaching in how to talk to their doctors about pain experienced 20 percent less discomfort in subsequent weeks, according to a UC Davis study published in the April 16 issue of the Journal of Clinical Oncology.
The study of 87 patients at the UC Davis Cancer Center and Kaiser Permanente was conducted by Richard Kravitz, a professor of medicine and director of the UC Davis Center for Health Services Research in Primary Care, and Jennifer Wright Oliver, a medical student at UC Davis Medical Center.
"We motivated patients to be more effective when they talk with their doctors about pain," said Kravitz. "This approach has been used in people with diabetes and other chronic diseases, but ours was the first time it had been used in cancer. As an intervention, it shows promise in helping cancer patients."
An estimated 42 percent of cancer patients do not get sufficient relief from pain, not because their pain can’t be controlled but because of patient-doctor communication barriers. These include patients not knowing their options or fearing being perceived as "bad" patients for talking about pain. Some patients worry that treating pain may keep their physician from treating their cancer aggressively, said Kravitz. Others fear they will become addicted to pain medications.
In the study, counselors in the experimental group met for 15 minutes with cancer patients to design an individualized program for pain relief. They asked patients about their beliefs on pain management and had them set goals, such as being able to attend a family gathering or sleep through the night without pain. They would also rehearse what patients would ask for in future visits with their doctors.
The control group received a 15-minute educational session on pain control. In subsequent follow-ups, the patients who had received individualized coaching showed a 20 percent overall reduction in average pain. Both groups showed improvements in pain-related knowledge.
The study underscores the need to involve cancer patients more actively in pain management decisions, said Kravitz. "Health-care professionals need to determine their patient’s attitudes about pain and encourage them to discuss the subject openly," he said. "This is not necessarily easy, because patients are often reluctant to disclose their pain."
The authors recommend further study on a larger sample of cancer patients to confirm its effectiveness. Copies of all news releases from UC Davis Health System are available on the Web at http://news.ucdmc.ucdavis.edu.
The study was funded by a grant from the Bayer Health Communications Institute.
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