Background

Despite existing guidelines to assess and manage pain, the management of cancer-related pain is often suboptimal with patients often being undertreated. Inadequate pain management may be due to patient-related barriers. Educating patients may decrease these barriers. However, the effect of pain education on patient-related outcomes is still unclear. This review aimed to study the effect of educational interventions on cancer-related pain.

Design

We performed a systematic review of randomized controlled trials (RCTs) identified from Medline and Cinahl, from 1995 to May 2017.Two reviewers independently selected trials comparing educational intervention to usual care or an active control intervention. The methodological quality was assessed and data extraction was done independently. Primary outcome measures were pain intensity and interference. Secondary outcome measures were knowledge/barriers, medication adherence and self-efficacy.

Results

Twenty-six RCTs totaling 4735 patients met our inclusion criteria. Compared to the control group, 31% of the studies (including 19% of all patients) reported a significant difference in pain intensity in favor of the intervention group. Twelve studies measured pain interference and four (30%) found a significant improvement. With regard to secondary endpoints, significant differences in favor of the experimental arms were found for pain knowledge or barriers (15/22 studies; 68%), medication adherence (3/6 studies; 50%) and self-efficacy (1/2 studies).

Conclusions

Patient-based pain educational programs may result in improvements of relevant patient-reported outcomes. However, the interventions are heterogeneous and improvement of pain was only seen in less than one third of the studies and in less than 20% of all included patients.

中文翻译：

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对以患者为基础的教育干预措施改善与癌症相关的疼痛的有效性的系统评价

背景

尽管已有评估和治疗疼痛的指南，但与癌症相关的疼痛的治疗常常欠佳，患者往往得不到充分的治疗。疼痛管理不充分可能是由于患者相关的障碍。对患者进行教育可能会减少这些障碍。但是，疼痛教育对患者相关结局的影响仍不清楚。这篇综述旨在研究教育干预对癌症相关疼痛的影响。

设计

我们对1995年至2017年5月从Medline和Cinahl鉴定出的随机对照试验（RCT）进行了系统的回顾。两名评论者独立选择了将教育干预与常规护理或主动对照干预进行比较的试验。评估方法学质量，并独立进行数据提取。主要结局指标为疼痛强度和干预。次要结局指标是知识/障碍，药物依从性和自我效能。

结果

总计4735名患者的26项RCT符合我们的纳入标准。与对照组相比，有31％的研究（包括所有患者的19％）报告了疼痛强度的显着差异，有利于干预组。十二项研究测量了疼痛干扰，其中四项（30％）发现有显着改善。关于次要终点，在疼痛知识或障碍（15/22研究； 68％），药物依从性（3/6研究； 50％）和自我效能感（1/2）方面，发现对实验组的支持存在显着差异。学习）。

结论

基于患者的疼痛教育计划可能会改善患者报告的相关结果。但是，干预措施是不同的，疼痛的改善仅在不到三分之一的研究中以及在所有纳入的患者中的不到20％才能见到。