Pain management is critical throughout cancer care, from diagnosis through treatment and survivorship, and in advanced illness and at the end of life. Improving cancer pain management is critical over the next decade, given (1) more number of cancer survivors with long-term consequences of cancer and its treatment, (2) longer survival with advanced cancer, with more time with and complexity of pain, and (3) growing evidence that chronic opioids are often ineffective and have many adverse effects and risks. Cancer pain is often challenging; it interacts with many issues, including psychological and social concerns and other symptoms, especially fatigue and sleep disturbances. Severe cancer pain is still frequent in the United States; the quality of pain management is often suboptimal; key effective nonpharmacologic strategies, such as rehabilitation, and psychosocial approaches, such as patient education and support, are underused; and disparities in management persist. A key solution, using a biopsychosocial approach, considers not only biological aspects, but other related symptoms and interactions with psychological (e.g., distress, mood) and social (e.g., culture, family, financial stressors) factors. The effectiveness of biopsychosocial approaches is well-established, but improving use in cancer care requires both interdisciplinary health professional education and quality improvement approaches. This education program is based on the extensive health professional education programs at Johns Hopkins Bloomberg School of Public Health and Medicine and supportive oncology education programs of the City of Hope. The overall goal is to improve US capacity for biopsychosocial cancer pain management. To accomplish this, we will train 360 cancer care professionals (physicians, nurses, social workers and others) over the award. In a 15-week program, participants will participate in 8 webinars, an online simulation program, a 2-day intensive skills-based workshop, and 2 pre-workshop preparatory and 4 post- workshop implementation faculty-participant conference calls.
The aims are to (1) implement a curriculum for training healthcare professionals in principles of biopsychosocial cancer pain management and quality improvement, (2) sustain and refine newly acquired pain management and quality improvement skills through ongoing support and building a networking community, and (3) assess the effectiveness of the education after the program and sustainability at one year. An expert team of faculty, advisors and patient advocates will plan, produce, and evaluate the program, including experts in professional and executive education, pain management and associated issues and symptoms, skills-based supportive oncology education and quality of care. The Principal Investigators have combined decades of experience in educating health professionals in biopsychosocial pain management and program development. We have support from local and national cancer networks and organizations to recruit a diverse, qualified participant pool and support implementation into practice, with the goal of improving patient care and outcomes.
Cancer pain continues to significantly impact patients' quality of life and experience of cancer and its treatments. Improving health care professionals' skills for addressing biopsychosocial aspects of cancer pain and developing programs to integrate these approaches into cancer care can improve outcomes for patients. We propose to address these needs through a program integrating online training and simulation, a skills- based workshop, and ongoing faculty mentoring and online networking.
