Opioid Titration in the Hospice Setting: Barriers Assessment and Modification of the Model Order Sheet and Protocol

Study Overview
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Brief Summary
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The purpose of this study is to modify the opioid titration order sheet to meet the needs of the outpatient hospice population and to conduct a pilot trial to assess feasibility, utility, and derive preliminary efficacy data.

Conditions
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Cancer Pain

Intervention / Treatment
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* Other: Individual patient interview, focus group and structured survey
* Other: interview, focus group and structured survey
* Other: interview, focus group and structured survey
* Other: interview, focus group and structured survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient eligibility includes: Alive Hospice outpatient Diagnosis of carcinoma Pain requiring fixed dose opioids Age > 21 years Not pregnant or lactating Willing and able to sign informed consent Able to speak/comprehend English Caregiver eligibility will include: Caregiver for an Alive Hospice patient Willing and able to sign informed consent Able to speak/comprehend English Hospice Staff eligibility will include: Currently on staff at Alive Hospice Willing and able to sign informed consent Able to read/speak English. Referring Physician eligibility will include: Having recently referred patients to Alive Hospice Willing and able to sign informed consent and able to read/speak English. Exclusion Criteria: patients < 21 years of age pregnant or lactating patients, caregiver and or Hospice staff that does not speak/comprehend English

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Caregiver<br>Family members will be asked to complete a demographic survey, an assessment of the patient's current pain, and a series of questionnaires including: Caregiver Pain Medicine Questionnaire, the Stressful Caregiving Adult Reactions To Experiences of Dying Scale, and the Caregivers' Self Efficacy in Pain Management Questionnaire. Upon completion of the questionnaires, patients and caregivers will be interviewed separately. | Other: interview, focus group and structured survey<br> <br> |
| Hospice staff<br>Hospice staff will be asked to complete the Pain Knowledge and Attitudes survey. They will also complete the Technology Acceptance Model (TAM) questionnaire to assess the perceived utility of an opioid titration order sheet to help manage pain control. A demographic survey will also be completed. | Other: interview, focus group and structured survey<br> <br> |
| Referring physician<br>Referring physicians will be asked to complete the Pain Knowledge and Attitudes survey as well as the TAM questionnaire and Demographic Survey. | Other: interview, focus group and structured survey<br> <br> |
| Patient<br>Demographic information includes education, marital status, number in household, and employment status will be obtained from patient. Clinical data will be obtained from the patient's medical records. Information to be obtained will include information about the type of cancer, stage of disease, time since diagnosis, current treatment for cancer, type of pain, time since onset of pain, and time of first opioid prescription. The patient will also take a pain assessment survey. | Other: Individual patient interview, focus group and structured survey<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adequate pain control |  | Until death. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Oncology Pain Management in outpatient hospice setting