Patient Education, Coaching, and Self-Management for Cancer Pain

1. Melanie R. Lovell⇑, 
2. Tim Luckett, 
3. Frances M. Boyle, 
4. Jane Phillips, 
5. Meera Agarand 
6. Patricia M. Davidson

+Author Affiliations

1. Melanie R. Lovell and Meera Agar, HammondCare; Melanie R. Lovell and Frances M. Boyle, University of Sydney; Melanie R. Lovell, Tim Luckett, Jane Phillips, Meera Agar, and Patricia M. Davidson, ImPaCCT (New South Wales Palliative Care Trials Group); Tim Luckett and Patricia M. Davidson, University of Technology Sydney; Jane Phillips, University of Notre Dame; and Meera Agar, University of New South Wales, Sydney, New South Wales, Australia.

1. Corresponding author: Melanie R. Lovell, MBBS, PhD, FRACP, FAChPM, 97-115 River Rd, Greenwich NSW 2065, Australia; e-mail: mlovell@hammond.com.au.

Abstract

Purpose Multiple systematic reviews and meta-analyses have identified the effectiveness of patient education in improving cancer pain management. However, the mechanisms by which patient education improves pain outcomes are uncertain, as are the optimal delivery, content, timing, frequency, and duration. This review provides best-bet recommendations based on available evidence to guide service managers and clinicians in developing a patient education program.

Methods We used patient-centered care, self-management, coaching, and a behavior change wheel as lenses through which to consider the evidence for elements of patient education most likely to be effective within the context of other strategies for overcoming barriers to cancer pain assessment and management.

Results The evidence suggests that optimal strategies include those that are patient-centered and tailored to individual needs, are embedded within health professional–patient communication and therapeutic relationships, empower patients to self-manage and coordinate their care, and are routinely integrated into standard cancercare. An approach that integrates patient education with processes and systems to ensure implementation of key standards for pain assessment and management and education of health professionals has been shown to be most effective.

Conclusion Patient education is effective in reducing cancer pain and should be standard practice in all settings. For optimal results, patient education should be integrated with other strategies for implementing evidence-based, person-centered care and overcoming barriers at the levels of patient, provider, and health system.