Recent data demonstrate that unrelieved cancer pain is a significant problem in the ambulatory oncology population. Patients report experiencing moderate to severe pain that interferes with functional abilities and has deleterious effects on quality of life. Our data, as well as work by others, suggest that research must be done to test the effectiveness of specific interventions to improve the outpatient's ability to more effectively manage cancer-related pain. Therefore, this study will test the effectiveness of an intervention designed using self- care theory, as well as the principles of """"""""academic detailing"""""""" and nurse coaching, compared to the provision of only written information about pain management using the consumer version of the AHCPR cancer pain guideline, in decreasing the patients' pain intensity score, improving the patients' functional status, and improving the patients' quality of life. Adult oncology patients (N=320) experiencing pain from bone metastasis will be recruited from 8 outpatient sites in urban and rural areas of California. Patients will be stratified by site and based on whether or not they have an identified family caregiver, who agrees to participate in the study. Patients without a family caregiver will be randomized to either the PRO- SELF(C): PAIN CONTROL group or the AHCPR group. Patients with a family caregiver will be randomized to either the PRO-SELF(C):PAIN CONTROL group or the AHCPR group. The patient and the family caregiver will receive the intervention together. Baseline data will be collected on all patients and family caregivers. Patients and patient-caregiver dyads, in the PRO-SELF(C) groups, will receive the PRO-SELF(C):PAIN CONTROL intervention, for 6 weeks, during office visits and follow-up coaching phone calls. Weekly data collection will include measurement of pain intensity. Patients and patient-caregiver dyads, in the AHCPR groups, will be called and seen with the same frequency as the PRO-SELF(C) groups. Both of the PRO-SELF(C) groups and the AHCPR groups will be seen in the office at the end of week 6 to complete the data collection. Data will be analyzed using parametric statistics to determine if there is a decrease in the patients' pain intensity score, an improvement in functional status, and an improvement in quality of life in both PRO-SELF(C) groups compared to the AHCPR groups (i.e., patient or patient/caregiver dyad).

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Nursing Research Study Section (NURS)
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University of California San Francisco
Other Health Professions
Schools of Nursing
San Francisco
United States
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Miaskowski, Christine; Aouizerat, Bradley E (2012) Biomarkers: symptoms, survivorship, and quality of life. Semin Oncol Nurs 28:129-38
Langford, Dale J; Paul, Steven M; Tripathy, Debu et al. (2011) Trajectories of pain and analgesics in oncology outpatients with metastatic bone pain during participation in a psychoeducational intervention study to improve pain management. J Pain 12:652-66
Langford, Dale J; Tripathy, Debu; Paul, Steven M et al. (2011) Trajectories of pain and analgesics in oncology outpatients with metastatic bone pain. J Pain 12:495-507
Villars, Patrice; Dodd, Marylin; West, Claudia et al. (2007) Differences in the prevalence and severity of side effects based on type of analgesic prescription in patients with chronic cancer pain. J Pain Symptom Manage 33:67-77
Miaskowski, Christine; Dodd, Marylin; West, Claudia et al. (2007) The use of a responder analysis to identify differences in patient outcomes following a self-care intervention to improve cancer pain management. Pain 129:55-63
Paul, Steven M; Zelman, Diane C; Smith, Meredith et al. (2005) Categorizing the severity of cancer pain: further exploration of the establishment of cutpoints. Pain 113:37-44
Schumacher, Karen L; Koresawa, Setsuko; West, Claudia et al. (2005) Qualitative research contribution to a randomized clinical trial. Res Nurs Health 28:268-80
Edrington, Janet M; Paul, Steven; Dodd, Marylin et al. (2004) No evidence for sex differences in the severity and treatment of cancer pain. J Pain Symptom Manage 28:225-32
Miaskowski, Christine (2004) Psychoeducational interventions for cancer pain serve as a model for behavioral research. Commun Nurs Res 37:51, 53-71
Kim, Jung-Eun; Dodd, Marilyn; West, Claudia et al. (2004) The PRO-SELF pain control program improves patients' knowledge of cancer pain management. Oncol Nurs Forum 31:1137-43

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