Cancer Pain Management: The Role of the Palliative Care Team
SAN ANTONIO--Embedding palliative care teams into oncology care centers can be highly effective in improving pain management and integrating patient care, but requires strong support from clinical and administrative leaders, according to research presented at the American Academy of Pain Management (AAPM) Annual Meeting.1
“The West Cancer Center, a major provider of oncologic services to patients in the Mid-South, sought to improve the quality of pain management within [its] patient population, as well as to more fully integrate care. An embedded palliative care clinic was begun as a pilot program to achieve these ends,” wrote the authors.
The palliative care team employs different approaches to address chemotherapy-induced neuropathy and is also considering the use of vitamin D to mitigate neuropathy associated morbidity. Nutritionists and psychologists take part in patients' care to address other comorbid symptoms, including anxiety and depression.
To assess the progress of this pilot project and identify future directions for research, the team conducted a chart review of the West Cancer Center's administrative and clinical activity from September 2014 to August 2016.
A default survey that comprised of 54 questions was initially selected to assess program success. As few patients completed this survey, likely due to its lengthy nature, physicians shortened it to 10 questions dealing with the most prevalent symptoms they observed in their patient population. They then also required patients to fill out this survey prior to evaluation by their physician.
During the period of the program, the West Cancer Center achieved major improvements in its practice management, including:
- Installment of protocols for automated referrals
- Mechanisms to insure best practices for managing controlled substances
- Integration of various aspects of the Cancer Center into patient care, including navigation, care support, physical therapy, nutritional support, psychologic services, and lymphedema therapy
In addition, this analysis showed success in recruiting patients and raising their overall satisfaction levels.
“Embedded palliative care teams can be highly effective in transforming care within establishing centers of excellence in oncology, but require robust support from clinical and administrative leaders,” the authors concluded. “Having proven our model is effective in episodic clinical care, we next seek to implement changes in care required by the Oncologic Care Model for a broad panel of selected patients.”
W. Clay Jackson, MD, is a member of the Speakers' Bureau at Sunovion Pharmaceuticals Inc, and is a shareholder of Aspire Healthcare.
- Wozny M, Mullinax G, Jackson WC. Embedding Palliative Care in a Cancer Center: Maximizing Pain Management. Presented at: AAPM 2016. September 22-25, 2016; San Antonio, Texas.