Informing Design of a Smart Phone Mobile Application to Improve Cancer Pain Management: A Survey of Cancer Care Institutions in Nepal (RP510)

Abstract Background One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may not be appropriate for the resource and cultural context of LMICs. Objectives This research represents a collaboration between the University of Virginia and the Nepalese Association of Palliative Care (NAPCare) to design a mobile health application (‘app’) to scale-up implementation of existing locally developed PMG. Methods We conducted a cross-sectional survey of clinicians within Nepal to inform design of the app. Questions focused on knowledge, beliefs, and confidence in managing cancer pain; barriers to cancer pain management; awareness and use of the NAPCare PMG; barriers to smart phone use and desired features of a mobile app. Findings Surveys were completed by 97 palliative care and/or oncology healthcare providers from four diverse cancer care institutions in Nepal. 49.5% (n = 48) had training in palliative care/cancer pain management and the majority (63.9%, n = 62) reported high confidence levels (scores of 8 or higher/10) in managing cancer pain. Highest ranked barriers to cancer pain management included those at the country/cultural level, such as nursing and medical school curricula lacking adequate content about palliative care and pain management, and patients who live in rural areas experiencing difficulty accessing healthcare services (overall mean = 6.36/10). Most nurses and physicians use an Android Smart Phone (82%, n = 74), had heard of the NAPCare PMG (96%, n = 88), and reported frequent use of apps to provide clinical care (mean = 6.38/10, n = 92). Key barriers to smart phone use differed by discipline, with nurses reporting greater concerns related to cost of data access (70%, n = 45) and being prohibited from using a mobile phone at work (61%; n = 39). Conclusions Smart phone apps can help implement PMG and support healthcare providers in managing cancer pain in Nepal and similar settings. However, such tools must be designed to be culturally and contextually congruent and address perceived barriers to pain management and app use.

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From Cancer Treatment to Cancer Survivorship: A Case Report Demonstrating the Dynamic Roles of Intrathecal Drug Delivery System in Various Phases of Cancer Care

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/131 ◽

2020 ◽

pp. 131-134

Author(s):

Po-Yi Paul Su

Keyword(s):

Drug Delivery ◽

Case Report ◽

Pain Management ◽

Cancer Pain ◽

Drug Delivery System ◽

Cancer Care ◽

Drug Delivery Systems ◽

Opioid Therapy ◽

Cancer Pain Management ◽

Intrathecal Drug Delivery

Background: Until the continued improvements in cancer diagnosis and treatment, many cancers were once considered terminal illnesses. Opioid-based therapy is frequently utilized from the armamentarium for cancer pain treatment since the immediate goals of acute cancer pain management are focused on alleviating pain severity and improving quality of life during this limited time – despite the risks of chronic opioid therapy. However, now, with an expanding cancer survivor population, we lack guidance and tools to assist health care providers and patients in pivoting the focus of cancer pain management from acute relief toward improving function, rehabilitation, and limiting the long-term adverse effects of pain and opioid therapy. Case Report: Here, we present a case exemplifying the ability of intrathecal drug delivery systems to serve a multitude of roles during the various phases of cancer care: from treating acute cancer-related pain, acting as a tool to wean systemic opioid therapy, to being clinically dormant in situ but ready to serve again in the event of cancer recurrence. Conclusion: Intrthecal drug delivery systems are effective tools in managing acute cancer pain and can also be adapted to help manage chronic pain in cancer survivors. Key words: Cancer pain, intrathecal drug delivery system, intrathecal pump, opioid weaning

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Pediatric cancer pain

Oxford Textbook of Pediatric Pain ◽

10.1093/med/9780198818762.003.0018 ◽

2021 ◽

pp. 168-180

Author(s):

Steven J. Weisman

Keyword(s):

Radiation Therapy ◽

Pain Management ◽

Cancer Pain ◽

Cancer Care ◽

Postoperative Chemotherapy ◽

Treatment Modalities ◽

Central Component ◽

Cancer Pain Management ◽

Pain Complaint ◽

Control Pain

Cancer pain management in children is reviewed in this chapter. It remains a central component of modern, compassionate cancer care. Cancer pain in children is predominantly from treatment and procedures. Even though many patients may present with an initial pain complaint, treatment will rapidly bring these presenting pain complaints under control. Pain then becomes postoperative, chemotherapy, radiation therapy, or complication related, rather than disease related. Intensive treatment modalities and repetitive painful procedures will dominate as etiologies of pain. Many options for pain management are available and reviewed in this chapter.

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Cancer pain management: Implications for psychologists

PsycEXTRA Dataset ◽

10.1037/e570662013-027 ◽

2013 ◽

Author(s):

Stacy A. Ogbeide

Keyword(s):

Pain Management ◽

Cancer Pain ◽

Cancer Pain Management ◽

Management Implications

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Cancer pain management

Orvosi Hetilap ◽

10.1556/oh.2014.29808 ◽

2014 ◽

Vol 155 (3) ◽

pp. 93-99

Author(s):

Péter Heigl

Keyword(s):

Quality Of Life ◽

Pain Management ◽

Pain Relief ◽

Life Expectancy ◽

Cancer Pain ◽

Cancer Pain Management ◽

Medical Activity ◽

Short Summary ◽

Adequate Quality

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.

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