Effect of Good Pain Management (GPM) Ward Program on Moderate to Severe Cancer Pain Patients

Study Overview
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Brief Summary
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This study aims to set up a standardized cancer pain ward - known as the Good Pain Management (GPM) Ward with streamlined assessment and management procedures to act as a pain management model. In particular, it will enforce regular pain assessment from and throughout hospital admission, and treatment protocols introducing the use of strong-opioids in moderate cancer pain patients, following National Cancer Care Network (NCCN) Adult Cancer Pain Guidelines. The GPM ward will be compared against current-practice controlled ward.

Detailed Description
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This is a double-arm, randomized, multi-center, current practice-controlled study. Approximately 150 cancer pain patients with collecting questionnaires admitted to an inpatient department from 3 national hospitals: Kaohsiung Medical University Hospital, Kaohsiung Municipal Ta-Tung Hospital and Kaohsiung Municipal HsiaoKang Hospital will be invited into this study. Eligible patients will be randomized to one of the following pain control wards in a 1:1 ratio. GPM Ward: Good Pain management ward Control Ward: Current practice-controlled ward Surveys, pain level measurements and dosage used will be collected in 48±8 hours. The pain management index (PMI) will be assessed as primary objective. The patient satisfaction, outcome questionnaire (APS-POQ) and SF-36 will be assessed in secondary objectives. Once patient is admitted to the ward and agrees to participate in the study, the patient will be randomly and blindly assigned to either GPM ward or Control Ward. In the Control Ward, patient will receive the current practice of pain management, with less assessment procedure. This study will investigate the benefits and effect of good pain control on patient outcomes in hospitalized cancer pain patients. The results aim to demonstrate the viability of GPM ward in daily practices and its measurable impact on the patient outcomes including patient treatment satisfaction as well as quality of life. Primary objectives: • To assess pain management index (PMI) Secondary objectives: (1) To assess the satisfaction of pain control during admission (2) To analyze the Patient Outcome Questionnaire (APS-POQ) (3) To analyze the SF-36 Questionnaire

Official Title
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Evaluation of the Effect of Good Pain Management (GPM) Ward Program on Pattern of Care and Patient-Reported Outcomes of Moderate to Severe Cancer Pain Patients

Conditions
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Cancer, Pain

Intervention / Treatment
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* Other: Good pain management (GPM) procedure
* Other: Current practice procedure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females and males aged ≥ 20 Understand Chinese/Taiwanese and able to finish the questionnaire Alert enough to respond and understand Hospitalized for ≥ 24 hours ECOG ≤ 2 Cancer patients with cancer-related pain Exclusion Criteria: Patient diagnosed with non-cancer pain or unexplained pain Patient with moderate to severe mental disorder Patient receiving operation or invasive procedure within 24 hours before admission

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: GPM Ward<br>Good Pain management ward | Other: Good pain management (GPM) procedure<br>* In the GPM ward, a close pain assessment will be carried within 1 hour after admission. After the assessment, patient will be given analgesic treatment as needed, by acceptable route, frequency and dosage. A good titration is required in GPM ward. Patient will be close monitor his/her pain level regarding pain score. In opioid use, when patient complains patient level ≥ 4, low dose strong opioids will be introduced in patient suffering with moderate pain. Compare with current practice, GPM ward will perform pain assessment with higher frequency for adjusting of analgesic medications if required.<br>|
| Active Comparator: Control Ward<br>Current practice controlled ward | Other: Current practice procedure<br>* Current practice clinical procedure for pain management<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain management index (PMI) assessment | The change of mean PMI score, pain-reporting rate and adequacy of pain treatment using pain management index | Up to 56 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Satisfaction of pain control during admission | Patient satisfaction about pain control | Up to 56 hours | 
| Patient outcome questionnaire (APS-POQ) analysis | The analysis of APS-POQ outcome | Up to 56 hours | 
| SF-36 Questionnaire analysis | The analysis of SF-36 | Up to 24 hours in screening period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cancer pain, GPM, pain assessment