Self-management support of cancer-related pain in the home environment.
Pain is a well-known problem in the care for patients with cancer. From practice and scientific literature it can be concluded that different factors influence the pain management: a lack of knowledge with the patient, a lack of monitoring of symptoms and a lack of communication with care professionals. In this KWF-project it was investigated if self management and innovative technologies could provide improvements for patients in their home environment.
Effective self-management: how?
In self management it is important that patients have access to knowledge, skills and insights in their own situation. This allows them to judge symptoms, take decisions and follow-up actions. Support of care professionals is extremely valuable in this process. Self management and monitoring tools allow space for experimenting and making mistakes in a supported environment, so that patients get the confidence that they can actually care for theirselves. These prerequisites have been integrated in the setup of the care program.
Diary, medication, knowledge and contact.
The TelePain intervention, which is created together with IDEE and Sananet BV, consists of an iPad application for patients and a web application for care providers. Patiënts register pain, related symptions and medication usage on a daily basis. They receive feedback on their historical experiences in the form of a graphic. Knowledge is provided and text messages can be exchanged with their care providers, who also have access to the data. This allows them to monitor their patients, provide support and communicate with the doctor in charge of the pain treatment. The care providers that have cooperated in the co-development of this program are Paul Oyen, Eliane Perrée en Marij Schielke.
Pilot: Can patients and care providers use the program in practice?
After the development phases, both applications have been tested for usability and technical performance in a pilot study with 11 patients. Patiënts were positive about the application and the care providers’ support. Monitoring and providing remote support has proven to be a challenging and useful activity.
RCT: Is the program effective?
A randomized controlled trial was started in 2014 to measure the effect of the intervention on pain intensity and quality of living.
Core aspects of the research program:
Design: RCT with intervention group (self management support) and control group (regular care)
Region: MUMC+ and Atrium MC
Patiënts: diagnosed with cancer (curative/ palliative), cancer related pain (NRS ≥4) > 2 weeks, living at home.
Inclusion: through doctors (oncologist, radiotherapist, family doctor)
Follow-up: 12 weeks (questionnaire on baseline, after 4 and 12 weeks)
* Smartphone application currently available on Android.
Original text, see link.
- Tailored e-health service, for care organizations
- Commercialization license