Division of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.
J Palliat Med. 2024 Sep;27(9):1171-1176. doi: 10.1089/jpm.2024.0025. Epub 2024 Jun 20.
Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. We conducted a retrospective analysis of cases presented at CPB between May 2021 and June 2022 and a cross-sectional analysis of CBP participant surveys. Among 28 cases included for analysis, gastrointestinal cancers ( = 7, 25.9%) and multiple myeloma ( = 5, 18.5%) were the most frequent cancer diagnoses. Primary reasons for referral were SUD ( = 22, 78.6%) and provider/team distress ( = 13, 46.4%). The most frequent recommendations made at CBP were encouraging interdisciplinary collaboration ( = 18, 64.3%), maintaining healthy boundaries ( = 15, 53.6%), and SUD management ( = 13, 46.4%). Of 14 scheduled meetings, most meetings involved the presentation of ≥1 cases ( = 12, 86%). Among 40 CBP participant surveys, most attendees ( = 38, 95%) were likely or highly likely to continue to attend. CPB is a feasible and acceptable intervention that allows for palliative care clinicians to collaborate and receive interdisciplinary team feedback and peer support on the management of patients with cancer-related pain and concurrent SUD and/or psychosocial complexity in the ambulatory care setting. A regular, interdisciplinary team meeting (CPB) is a feasible and acceptable intervention to help palliative care clinicians manage challenging cases involving patients with cancer and concurrent SUD and/or psychosocial complexity.
癌症相关疼痛和并存物质使用障碍（SUD）的患者给姑息治疗临床医生带来了一系列独特的挑战。需要一个结构化的跨学科合作论坛，以有效地管理这个复杂的人群。描述姑息治疗复杂疼痛委员会（CPB）的可行性和可接受性，这是一个跨学科团队会议，为癌症相关疼痛和并存 SUD 和/或心理社会复杂性的患者提供具体的护理建议。我们对 2021 年 5 月至 2022 年 6 月期间在 CPB 提出的病例进行了回顾性分析，并对 CPB 参与者调查进行了横断面分析。在纳入分析的 28 例病例中，胃肠道癌症（=7，25.9%）和多发性骨髓瘤（=5，18.5%）是最常见的癌症诊断。转诊的主要原因是 SUD（=22，78.6%）和提供者/团队的困扰（=13，46.4%）。CPB 最常提出的建议是鼓励跨学科合作（=18，64.3%）、保持健康的界限（=15，53.6%）和 SUD 管理（=13，46.4%）。在 14 次预定的会议中，大多数会议涉及至少 1 个病例的介绍（=12，86%）。在 40 份 CPB 参与者调查中，大多数参与者（=38，95%）很可能或极有可能继续参加。CPB 是一种可行和可接受的干预措施，允许姑息治疗临床医生在门诊环境中合作，并获得跨学科团队的反馈和同行支持，以管理癌症相关疼痛和并存 SUD 和/或心理社会复杂性的患者。定期的跨学科团队会议（CPB）是一种可行和可接受的干预措施，可以帮助姑息治疗临床医生处理涉及癌症和并存 SUD 和/或心理社会复杂性的患者的挑战性病例。
