Abstract
In the field of cancer pain, therapeutic patient education (TPE) allows patients to develop skills to better manage their pain. In the Lower Normandy region of France, the management of pain is based on networking, thus allowing proximity and accessibility for all concerned. We have thus designed and initiated a broad five-stage research program that includes the following: (1) training for caregivers in TPE; (2) identifying the educational expectations of patients and their relatives with regard to cancer pain; (3) the design of a TPE program; (4) the evaluation of its quality; and (5) the evaluation of its effectiveness by comparative randomization. This article presents this approach and more particularly the research phases (stages 2, 4, 5) for which the objectives, the methodology, and the expected results are justified. Among the key points, particular attention is paid to the evaluation of the educational dimension that provides patients with self-efficacy to participate actively in the management of their pain, their perception of changes in relation to it and its impact. The choice of a specific assessment criterion (subscale 9 of the Brief Pain Inventory) and of the step-wedge design are thus argued. This approach, which is based on a partnership between health care professionals and researchers, aims to demonstrate the benefits provided by TPE to patients in order to enable them to better manage their pain on a daily basis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sandrin-Berthon B (2010) Diagnostic éducatif ou bilan éducatif partagé ? Med Mal Metab 4:38–43
Van den Beuken-van Everdingen MHJ, Hochstenbach LMJ, Joosten EAJ, Tjan-Heijnen VCG, Janssen DJA (2016) Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manag 51:1070–1090
Kroenke K, Theobald D, Wu J, Loza JK, Carpenter JS, Tu W (2010) The association of depression and pain with health-related quality of life, disability, and health care use in cancer patients. J Pain Symptom Manag 40:327–341
Brant JM (2010) The global experience of cancer pain. Asian Pac J Cancer Prev 11(Suppl 1):7–12
Kwon JH (2014) Overcoming barriers in cancer pain management. J Clin Oncol 32:1727–1733
Prevost V, Delorme C, Grach MC, Chvetzoff G, Hureau M (2016)Therapeutic education in improving cancer pain management: a synthesis of available studies. Am J Hosp Palliat Care 33:599-612
Adam R, Bond C, Murchie P (2015) Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials. Patient Educ Couns 98:269–282
Poulain P, Michenot N, Ammar D, Delorme C, Delorme T, Diquet B, Filbet M, Hubault P, Jovenin N, Krakowski I, Morere J-F, Rostaing S, Serrie A (2012) Mise au point sur l’utilisation du fentanyl transmuqueux chez le patient présentant des douleurs d’origine cancéreuse (version longue). Doul et Analg 25:102–117
Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 13:129–138
Larue F, Colleau SM, Brasseur L, Cleeland CS (1995) Multicentre study of cancer pain and its treatment in France. BMJ 310:1034–1047
Cleeland CS, Body JJ, Stopeck A, von Moos R, Fallowfield L, Mathias SD, Patrick DL, Clemons M, Tonkin K, Masuda N, Lipton A, de Boer R, Salvagni S, Oliveira CT, Qian Y, Jiang Q, Dansey R, Braun A, Chung K (2013) Pain outcomes in patients with advanced breast cancer and bone metastases: results from a randomized, double-blind study of denosumab and zoledronic acid. Cancer 119:832–838
Zelman DC, Cleeland CS, Howland EW (1987) Factors in appropriate pharmacological management of cancer pain: a cross-institutional investigation. Pain (Suppl) S136
Guelfi JD (1996) L'évaluation clinique standardisée en psychiatrie. Tome 1. Psychopathologie générale, dépression, anxiété et anxiodépression. Éditions Médicales Pierre Fabre, Boulogne
Boureau F, Luu M, Doubrère JF (1992) Comparative study of the validity of four French McGill Pain Questionnaire (MPQ) versions. Pain 50:59–65
Marquié L, Duarte L-R, Mauriès V, Izard P, Pouymayou J (2008) Les caractéristiques psychométriques du Questionnaire de douleur de Saint-Antoine en consultation d’algologie chez les personnes atteintes de cancer. Doul et Analg 21:52–61
Street RL Jr, Slee C, Kalauokalani DK, Dean DE, Tancredi DJ, Kravitz R (2010) Improving physician-patient communication about cancer pain with a tailored education-coaching intervention. Patient Educ Couns 80:42–47
Fischer D, Stewart AL, Bloch DA, Lorig K, Laurent D, Holman H (1999) Capturing the patient’s view of change as a clinical outcome measure. JAMA 282:1157–1162
Minaya P, Baumstarck K, Berbis J, Goncalves A, Barlesi F, Michel G, Salas S, Chinot O, Grob JJ, Seitz JF, Bladou F, Clement A, Mancini J, Simeoni MC, Auquier P (2012) The CareGiver Oncology Quality of Life questionnaire (CarGOQoL): development and validation of an instrument to measure the quality of life of the caregivers of patients with cancer. Eur J Cancer 48:904–911
Barlési F, Duffaud F, Doddoli C, Gimenez C, Auquier P, Favre R, Kleisbauer JP (2004) Impact of a brochure on pain destined for thoracic oncology patients. Presse Med 33(19 Pt 1):1313–1318
Rasmussen CD, Holtermann A, Mortensen OS, Søgaard K, Jørgensen MB (2013) Prevention of low back pain and its consequences among nurses’ aides in elderly care: a stepped-wedge multi-faceted cluster-randomized controlled trial. BMC Public Health 13:1088
Hussey MA, Hughes JP (2007) Cluster randomized crossover trials: design and analysis of the stepped wedge design. Contemp Clin Trials 28:182–191
Mdege ND, Man MS, Taylor CA, Torgerson DJ (2011) Systematic review of stepped wedge cluster randomized trials shows that design is particularly used to evaluate interventions during routine implementation. J Clin Epidemiol 64:936–948
Acknowledgements
The authors would like to thank Prof. Khaled Meflah (Director of the Center F. Baclesse), the Espace Régional d’Education Thérapeutique (ERET) in Lower Normandy, and Dr. Loudiyi-Mehdaoui (ARS) for their support, as well as Dr. Rodrigue Deleens for his contribution to the launch of the project. We also thank the patients and representatives of the associations who contributed to the design of this project and in particular Jocelyne Padéri (Association Francophone pour Vaincre les Douleurs) for her attentive and thoughtful involvement. All the patients and their relatives who have accepted (step 2) and will accept (steps 4 and 5) to participate in the clinical trials implemented within this broad research program are also thanked. We also thank Ray Cooke for help in editing the article.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Sources of Funding
The authors are grateful for the financial support of the Apicil Foundation and the ARDCOM (stage 1), the TAKEDA company (stage 2), the Departmental Committee of the Ligue contre le Cancer in Lower Normandy (step 4), and INCa (Invitation to tender RISP15-007_FP, stage 5).
Conflict of Interest
The authors declare that they have no conflicts of interest.
Rights and permissions
About this article
Cite this article
Prevost, V., Clarisse, B., Heutte, N. et al. Therapeutic Patient Education in Cancer Pain Management: from Practice to Research: Proposals and Strategy of the French EFFADOL Program. J Canc Educ 33, 1355–1361 (2018). https://doi.org/10.1007/s13187-017-1258-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-017-1258-8