Azizoddin Desiree R, Zhao Jian, DeForge Sara M, Chen Meng, Nipp Ryan, Stagg Jennifer Hardcopf, Bond Kerry, Leckie Raina, Hilton Blake T, Neil Jordan M, Tulsky James A, Pirl William, Edwards Robert R, Darnall Beth D
Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Cancer Med. 2025 May;14(9):e70898. doi: 10.1002/cam4.70898.
Patients with cancer have limited access to comprehensive pain treatment. We developed a 90-min, single-session, telehealth, interdisciplinary intervention that combines cancer-specific medical education and behavioral pain treatment. We evaluated the intervention's preliminary feasibility and acceptability for patients with cancer-related pain.
Adults with cancer-related pain (≥ 4/10, average pain) who are receiving cancer treatment (< 3 months) self-enrolled or were recruited from the Stephenson Cancer Center (SCC) in Oklahoma. Patients completed a baseline survey and attended the 90-min group-based, Zoom-delivered telehealth intervention. They completed post-intervention, 2-week, and 4-week follow-up assessments and an optional debriefing interview. The feasibility benchmark was ≥ 70% attendance and 80% of acceptability items rated ≥ 4/5.
Seventy participants (67.5% female; mean age = 52.5 years; 25% rural-dwelling) enrolled. Forty of 70 (57%) attended the intervention. Of those, 95% completed the post-intervention survey, and 90% and 95% completed the 2-week and 4-week follow-ups, respectively. Participants reported high acceptability, understandability (97%), and relevance (90%). Most (80%) would recommend the class to others. Qualitative feedback highlighted reduced helplessness and fear regarding opioid use, adoption of behavioral pain management strategies, and appreciation for the convenience of telehealth. Exploratory analyses showed significant reductions in pain intensity (mean difference [MD] = 1.27, p = 0.001), pain interference (MD = 5.48, p = 0.017), pain catastrophizing (MD = 6.0, p = 0.003), sleep disturbance (MD = 3.64, p = 0.004), and depression (MD = 3.97, p = 0.018) at 4 weeks.
While attendance was below feasibility benchmarks, this interdisciplinary, telehealth intervention was acceptable and improved self-reported cancer pain management. Further research will identify barriers to improve attendance, and determine the optimal timing within the cancer trajectory to deliver pain self-management content. Randomized controlled trials are needed to assess intervention efficacy on patient outcomes.
癌症患者获得全面疼痛治疗的机会有限。我们开发了一种为期90分钟的单节远程医疗跨学科干预措施，该措施结合了癌症特异性医学教育和行为疼痛治疗。我们评估了该干预措施对癌症相关疼痛患者的初步可行性和可接受性。
正在接受癌症治疗（<3个月）、患有癌症相关疼痛（≥4/10，平均疼痛程度）的成年人可自行报名或从俄克拉荷马州的斯蒂芬森癌症中心（SCC）招募。患者完成基线调查，并参加基于小组的、通过Zoom进行的90分钟远程医疗干预。他们完成干预后、2周和4周的随访评估以及一次可选的汇报访谈。可行性基准是出勤率≥70%，80%的可接受性项目评分≥4/5。
70名参与者（67.5%为女性；平均年龄=52.5岁；25%居住在农村）报名参加。70人中有40人（57%）参加了干预。其中，95%的人完成了干预后调查，90%和95%的人分别完成了2周和4周的随访。参与者报告了较高的可接受性、可理解性（97%）和相关性（90%）。大多数人（80%）会向他人推荐该课程。定性反馈突出了对阿片类药物使用的无助感和恐惧减少、行为疼痛管理策略的采用以及对远程医疗便利性的赞赏。探索性分析显示，4周时疼痛强度（平均差异[MD]=1.27，p=0.001）、疼痛干扰（MD=5.48，p=0.017）、疼痛灾难化（MD=6.0，p=0.003）、睡眠障碍（MD=3.64，p=0.004）和抑郁（MD=3.97，p=0.018）均有显著降低。
虽然出勤率低于可行性基准，但这种跨学科的远程医疗干预是可接受的，并改善了自我报告的癌症疼痛管理。进一步的研究将确定提高出勤率的障碍，并确定在癌症病程中提供疼痛自我管理内容的最佳时机。需要进行随机对照试验来评估干预措施对患者结局的疗效。
