Preliminary feasibility and acceptability of an interdisciplinary, single-session, telehealth class for patients with cancer-related pain.
Authors: Azizoddin Desiree Rachel , DeForge Sara Marie , Baltazar Ashton Riley , Darnall Beth , Bond Kerry , Leckie Raina , Hardcopf Stagg Jennifer , Hilton Blake T , Neil Jordan M , Nipp Ryan David , Edwards Robert R. 
Published: October 2023

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Background: Cognitive behavioral therapy for pain (pain-CBT) is the standard of care for pain management. However, few patients with cancer have access to this treatment. We developed a brief (90-minute), single-session, telehealth intervention that combines medical education (e.g., pain, opioids) with pain-CBT modified for patients with cancer. We sought to quantitatively and qualitatively evaluate the preliminary feasibility and acceptability of the class for patients with cancer-related pain. Methods: Adults with chronic, cancer-related pain (≥4/10) who were receiving or recently completed treatment (<3 months) self-enrolled or were recruited from Stephenson Cancer Center (SCC) in Oklahoma between January and June 2023. We excluded patients who did not speak English or who were experiencing cognitive impairment. After consent, patients completed a baseline survey and attended the 90-minute class offered once monthly on Zoom. Following attendance, the E-acceptability survey, with additional free-text feedback, and were invited to participate in a semi-structured qualitative interview. An initial benchmark for feasibility was set at ≥70% attendance. Results: While recruitment is still ongoing, 66 participants have consented; 22 (33%) withdrew due to being too ill, no longer having pain, or being a fraudulent sign-up ( n = 4, 6%). Of the 44 (67%) remaining participants, 27 (61%) have attended the class; remaining participants are scheduled for future attendance. Participants were 68% female, 89% white, 55 ( SD = 13.1) years of age, and diagnosed with various cancer types (gynecologic 32%, gastrointestinal 20%, head/neck 11%, etc.). Eleven participants (25%) lived in rural Oklahoma. Thirty (68%) participants were taking opioids (short-acting=57%, 48% long-acting=48%, both=36%). Average pain intensity (Brief Pain Inventory) was rated as 6.0/10 ( SD = 1.9). Attendees rated their overall satisfaction with the class as 4.50/5. Participants enjoyed the class (4.15/5), reported learning about pain (4.23/5), and found the material useful (4.31/5) and helpful (4.12/5). Attendees found the class enjoyable and informational, with one stating, “this class [gave] me some tools to better manage my pain...and tools to be able to find help if I need it” (65-year-old, F). Conclusions: To date, participants’ attendance in this single-session, interdisciplinary, telehealth cancer pain class was below our feasibility benchmark, with many requesting to attend future sessions or withdrawing due to being too ill or being lost to follow up. However, among those who have attended the class, they reported very high acceptability and satisfaction. Using qualitative interview feedback, we will tailor the intervention (e.g. more cancer-specific examples, provide a recording) to improve accessibility to this scalable, comprehensive cancer pain education class.