Department Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, 6500 HB, The Netherlands.
Implement Sci. 2011 Dec 6;6:126. doi: 10.1186/1748-5908-6-126.
One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR), has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change.
METHODS/DESIGN: A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners) and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity.
This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life.
[corrected] Netherlands Trial Register (NTR): NTR2739.
一半的癌症患者有疼痛。近二分之一有疼痛的癌症患者中，这种疼痛治疗不足。在这组患者中，仍然存在控制疼痛不足的重要问题。因此，2008 年制定了一项全国性的、循证的、多学科的临床实践指南，即“癌症患者的疼痛”。然而，发布指南是不够的。需要实施指南来改善疼痛管理。已经开发并试点测试了一种创新的实施策略，即短消息服务与交互式语音应答（SVS-IVR）。本研究旨在评估该策略提高疼痛报告、疼痛测量和充分疼痛治疗的效果。此外，患者在疼痛管理中的积极作用和护理人员的参与是否会发生变化。
方法/设计：将在荷兰东南部地区的 6 家医院的 6 个肿瘤门诊进行一项两臂的集群随机对照试验，其中 3 家医院为干预组，3 家为对照组。将在所有医院进行随访测量，以研究干预的长期效果。干预措施包括对专业人员（肿瘤内科医生、护士和全科医生）进行培训和使用 SMS-IVR 报告癌症患者的疼痛，以提高患者的疼痛报告、肿瘤内科医生、护士和全科医生的疼痛管理，并降低疼痛强度。
这种具有技术工具和患者参与的创新实施策略，可以增强“癌症患者的疼痛”指南在疼痛管理中的应用。短消息服务提醒可能是支持患者自我管理的一种工具。因此，SMS-IVR 干预可能会增加对生活的控制感。
荷兰试验注册处（NTR）：NTR2739。
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