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Design and validation of a medication assessment tool for cancer pain management

Håkonsen, Gro Dahlseng and Hudson, Steve and Loennechen, Thrina (2006) Design and validation of a medication assessment tool for cancer pain management. Pharmacy World and Science, 28 (6). pp. 342-351. ISSN 0928-1231

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Abstract

A clinical tool to examine prescribing in cancer pain management may provide a means to help establish acceptable standards of adherence to treatment guidelines. The study aim was to design and validate a Medication Assessment Tool for Cancer Pain Management (MAT-CP). The MAT-CP was designed from guideline criteria based on a previously developed method. The tool was validated by peer review before and during field-testing on a study sample of cancer patients experiencing pain. The final tool comprised 36 criteria covering six different aspects of cancer pain management: (1) pain assessment and information transfer, (2) start of strong opioid therapy; (3) current continuous analgesia; (4) current intermittent analgesia; (5) follow-up of therapy, and; (6) other care issues. The tool was tested on 109 cancer patients experiencing pain (57 males), mean (SD) age 60.8 (11.5) years. Guideline adherence overall was 61% (n = 1704 applicable criteria). The field-testing informed the modification of the MAT-CP to optimise its clarity and utility when applied to patients' clinical documentation. Good inter- and intra-rater reliability (Cohen's kappa κ = 0.86 and κ = 0.95, respectively) were demonstrated in the application. The preliminary application of the tool during field-testing has highlighted the following for further study: (a) Low adherence (<50%) to 14 standards concerning start of opioid treatment and pain therapy follow-up, clinical assessment of risk of gastro-intestinal adverse effects among patients on non-steroidal anti-inflammatory drugs (NSAID), current treatment of breakthrough pain, management of nausea/vomiting; (b) High adherence (>75%) to standards of prescribing of continuous analgesia. A clinical tool to examine prescribing in cancer pain management has been designed. Face and content validity have been informed by field-testing. The tool requires further study among palliative care specialists as part of the validation required before it can be recommended for clinical use.

Item type: Article
ID code: 4945
Keywords: clinical guidelines, clinical assessment tool, cancer pain, Norway, pain management, pharmaceutical care, prescribing, Pharmacy and materia medica, Pharmaceutical Science, Pharmacy, Toxicology, Pharmacology, Pharmacology (medical)
Subjects: Medicine > Pharmacy and materia medica
Department: Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences
Related URLs:
    Depositing user: Strathprints Administrator
    Date Deposited: 03 Dec 2007
    Last modified: 04 Sep 2014 17:32
    URI: http://strathprints.strath.ac.uk/id/eprint/4945

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