A Randomized Controlled Trial of a Standardized Educational Intervention for Patients with Cancer Pain

76 Background: Cancer pain affects 70-90% of advanced malignancy patients, resulting in impaired quality of life and increased healthcare utilization. Novel care delivery models are needed to optimize care for patients dealing with cancer-related pain in between clinic visits. ePAL is a smartphone application(app) that regularly monitors pain and uses artificial intelligence(AI) to differentiate urgent from non-urgent issues to intercede in real time. The purpose of this randomized controlled trial was to determine ePAL's impact on pain severity, attitudes toward cancer treatment, and healthcare utilization in patients with cancer pain. Methods: MGH Palliative Care Clinic Patients with pain from metastatic, solid-organ cancer (n=112) were recruited and randomized to either a control group (n=56) that received usual care or an intervention group (n=56) that used the ePAL app in addition to usual care for 8 weeks. The app assessed pain 3 times/week and questionnaires about pain (BPI), attitudes towards cancer treatment(BQ-II), and general anxiety(GAD-7) were given at 0, 4, and 8 weeks. A repeated measures mixed model approach assessed how outcome measures changed over time. Models controlled for baseline differences at enrollment and random slopes in addition to baseline depression score, age and sex(alpha=0.05). Results: Pain severity (BPI) and negative attitudes toward cancer pain treatment (BQ-II) decreased significantly for those using the app compared to controls(coeff. -0.09, 95% CI: -0.17, -0.007, p=0.034 and coeff. -0.037, 95% CI: -0.072, -0.001, p=0.042 respectively). Anxiety scores increased for those using ePAL compared to controls (coeff. 0.21, 95% CI: 0.039, 0.37, p=0.015). Over 8-weeks, ePAL users had 40% fewer inpatient hospital admissions compared to controls (n=15 vs. n=25, p=0.048). Conclusions: To our knowledge, this is the first mobile app to utilize AI and clinical algorithms to significantly decrease pain and reduce overall inpatient hospitalizations in patients with cancer-related pain. Clinical trial information: NCT02069743.

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A randomized controlled trial of an educational intervention on Hellenic nursing staff's knowledge and attitudes on cancer pain management

European Journal of Oncology Nursing ◽

10.1016/j.ejon.2005.07.006 ◽

2006 ◽

Vol 10 (5) ◽

pp. 337-352 ◽

Cited By ~ 26

Author(s):

Elisabeth I. Patiraki ◽

Elizabeth D.E. Papathanassoglou ◽

Cheryl Tafas ◽

Vasiliki Akarepi ◽

Stelios G. Katsaragakis ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pain Management ◽

Cancer Pain ◽

Educational Intervention ◽

Controlled Trial ◽

Cancer Pain Management ◽

Randomized Controlled ◽

Knowledge And Attitudes

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Efficacy of a combination of hypnosis and transcutaneous electrical nerve stimulation for chronic non‐cancer pain: A randomized controlled trial

Journal of Advanced Nursing ◽

10.1111/jan.14833 ◽

2021 ◽

Author(s):

Louise Tonye‐Geoffroy ◽

Stéphanie Mauboussin Carlos ◽

Sophie Tuffet ◽

Hélène Fromentin ◽

Laurence Berard ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cancer Pain ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Controlled Trial ◽

Electrical Nerve Stimulation ◽

Randomized Controlled

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Educational intervention to adopt selective laser trabeculoplasty as first-line glaucoma treatment: Randomized controlled trial: Educational intervention on selective laser trabeculoplasty

European Journal of Ophthalmology ◽

10.1177/11206721211018365 ◽

2021 ◽

pp. 112067212110183

Author(s):

Evelyn Tran ◽

Carina Sanvicente ◽

Lisa A Hark ◽

Jonathan S Myers ◽

Qiang Zhang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Usual Care ◽

Educational Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Selective Laser Trabeculoplasty ◽

First Line ◽

Randomized Controlled ◽

Laser Trabeculoplasty ◽

Glaucoma Treatment

Purpose: To determine the efficacy of an educational intervention on patient adoption and attitudes toward selective laser trabeculoplasty (SLT) as first-line treatment for glaucoma. Methods: This study is a randomized controlled trial. Subjects include 33 patients within 1-year diagnosis of either primary open-angle glaucoma, ocular hypertension, or pseudoexfoliation syndrome. After informed consent, subjects were randomly assigned to a Usual Care or Educational Intervention group. All subjects completed a pre-intervention questionnaire. The Educational Intervention group was shown a slideshow presentation and a 3-min video and given a post-intervention questionnaire. Follow-up examinations were reviewed for 6 months to determine subject completion of SLT, the primary outcome. Secondary outcomes include assessment of attitude toward SLT before and after intervention. Results: Age, gender, and baseline characteristics between the groups did not differ. The Usual Care group had a higher proportion of African Americans (77% vs 31%, p = 0.04). At 6 months following the intervention, 63% of subjects underwent SLT compared to 35% of Usual Care subjects ( p = 0.12). Older age was associated with decreased SLT uptake (OR 0.90, 95% CI 0.82–0.99, p = 0.03). Prior to the intervention, there were no differences in attitudes of both groups regarding SLT therapy. Nineteen percent of Educational Intervention subjects changed positively toward SLT ( p = 0.08) and 50% scheduled an SLT appointment after intervention ( p = 0.005). Conclusions: A slideshow and video-based educational intervention may positively enhance patient adoption of SLT. Clinical trial registration name, number, URL: Educational Intervention to Adopt SLT as First-Line Glaucoma Treatment, NCT03365778, https://clinicaltrials.gov/ct2/show/NCT03365778

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