Benefits of using the Brief Pain Inventory in patients with cancer pain: an intervention study conducted in Swedish hospitals

Viveka Andersson,Stefan Bergman,Hanna Simonsson,Ingela Henoch,Karin Ahlberg

doi:10.1007/s00520-019-05200-6

Abstract

PurposeThe prevalence of cancer pain is too high. There is a need for improvement of pain management in cancer care. The aim of this study was to explore whether the use of the multidimensional pain assessment questionnaire Brief Pain Inventory (BPI) could improve pain relief in hospitalized patients with cancer.MethodsA controlled intervention study was performed at two hospitals in western Sweden, 264 patients were included, 132 formed a control group and 132 an intervention group. All participants completed the BPI and the Edmonton Symptom Assessment Scale (ESAS) at baseline. Only the researcher had access to questionnaires from the control group. The completed forms from the intervention group were presented to the patients’ care team. A follow-up took place after 2–5 days when patients in both groups rated the scales a second time.ResultsIn the intervention group, significant differences in all measured items of the BPI were found at follow-up compared with baseline. Symptoms rated with the ESAS also decreased significantly, except shortness of breath. At follow-up, a significant increase in regular use of paracetamol, anti-neuropathic pain drugs and opioids was found, as well as elevated doses of fixed-schedule opioids. In the control group, differences between baseline and follow-up were significant regarding average pain and worst pain over the past 24 h.ConclusionPresenting the patient-reported BPI to the care team helped them to focus on patients’ pain, identify pain mechanisms and adjust analgesics accordingly. A possible explanation for the results is changes in the medication prescribed.

Highlights

MethodsThe prevalence of cancer pain is still far too high and has not improved significantly over the last decade [1], as compared to the four decades before [2]
A review article from 2016 reveals that pain occurs in 39% of patients after curative treatment, in 55% of those undergoing anticancer treatment and in 66% of those suffering from advanced cancer [3]. These figures are in line with those reported by the International Association for the Study of Pain (IASP) [4]
The aim of this study was to explore whether the use of the multidimensional pain assessment questionnaire Brief Pain Inventory (BPI) could improve pain relief in hospitalized patients with cancer

Summary

Introduction

MethodsThe prevalence of cancer pain is still far too high and has not improved significantly over the last decade [1], as compared to the four decades before [2]. A review article from 2016 reveals that pain occurs in 39% of patients after curative treatment, in 55% of those undergoing anticancer treatment and in 66% of those suffering from advanced cancer [3]. These figures are in line with those reported by the International Association for the Study of Pain (IASP) [4]. Barriers to adequate pain control have been identified, such as inadequate pain assessment, failure to use guidelines, reluctance to administer opioids, lack of knowledge, patients’ concerns about addiction and side effects as well as suboptimal education of healthcare professionals [7]

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Conclusion