Implementing a national clinical pathway for pain to ensure equitable, cost-effective, evidence based, person-centred care for people with advanced breast cancer

Project Member(s): Phillips, J., Davidson, P., Luckett, T., Ryan, L., Agar, M., Currow, D.

Funding or Partner Organisation: National Breast Cancer Foundation (National Breast Cancer Foundation - Translations Research Grants)

Start year: 2015

Summary: This project aims to ensure equitable access to evidence-based assessment and management of pain for people living with advanced breast and other cancers across Australia. Currently, quality of care is subject to a 'post-code lottery' resulting in under-identification, under-management and poor coordination for many people. This project will ensure minimal standards are met by means of the implementation, evaluation and dissemination of a national clinical pain pathway that gives step-by-step instructions on how to implement evidence-based pain screening, assessment and management supported by a suite of implementation resources, including: 1) a resource for people with cancer and their families that supports self-management, communication and coordination of care between different providers and ensures care remains centred on patient needs and priorities; 2) quality improvement resources and audit tools for services to monitor their processes and outcomes; and 3) an online training program called 'QStream' for health professionals. The pathway and resources will be made available free-of-charge on the Cancer Council Australia Cancer Guideline Wiki so they can be kept up to date and be accessible to services and patients in regional and rural areas where specialist services may be limited. Screening tools and patient resources will be translated to support communication between non-English speaking patients and their medical teams. Better management of pain has the potential to improve quality of life for most people with advanced breast and other cancers and reduce healthcare costs by avoiding unnecessary hospital admissions, supporting non-pharmacological approaches and quality use of medicines, and reducing caregiver distress.

Publications:

Luckett, T, Davidson, PM, Green, A, Marie, N, Birch, M-R, Stubbs, J, Phillips, J, Agar, M, Boyle, F & Lovell, M 2019, 'Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care', Palliative and Supportive Care, vol. 17, no. 04, pp. 472-478.
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Lovell, M, Luckett, T, Boyle, F, Stubbs, J, Phillips, J, Davidson, PM, Olver, I, von Dincklage, J & Agar, M 2015, 'Adaptation of international guidelines on assessment and management of cancer pain for the Australian context', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 11, no. 2, pp. 170-177.
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Phillips, JL, Lovell, M, Luckett, T, Agar, M, Green, A & Davidson, P 2015, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective', COLLEGIAN, vol. 22, no. 1, pp. 33-41.
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Lovell, M, Luckett, T, Phillips, J, Agar, M, Ryan, L, Lam, L, McCaffrey, N, Boyle, F, Stubbs, J, Shaw, T, Currow, D, Hosie, A & Davidson, P 1970, 'CLINICAL TRIAL PROTOCOL - IMPLEMENTING CLINICAL PRACTICE GUIDELINES FOR CANCER PAIN IN ADULTS TO ENSURE EQUITABLE, COST-EFFECTIVE, EVIDENCE-BASED, PERSON-CENTRED CARE: A PHASE III PRAGMATIC STEPPED WEDGE CLUSTER RANDOMISED CONTROLLED TRIAL OF GUIDELINES AND SCREENING WITH IMPLEMENTATION STRATEGIES VERSUS GUIDELINES AND SCREENING ALONE TO IMPROVE PAIN IN ADULTS WITH CANCER ATTENDING OUTPATIENTS ONCOLOGY AND PALLIATIVE CARE CENTRES', Asia-Pacific Journal of Clinical Oncology, pp. 162-162.

Lovell, MR, Phillips, J, Luckett, T & Agar, M 2015, 'Improving the system for managing cancer pain', pp. 361-362.
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Spencer, L, Luckett, T, Morton, R, Silvester, W, Pollock, C, Sellars, M, Detering, K, Tong, A, Butow, P & Clayton, J 2015, 'A SURVEY OF CLINICIANS' PRACTICES AND ATTITUDES TO ADVANCE CARE PLANNING FOR PATIENTS WITH CHRONIC KIDNEY DISEASE', WILEY-BLACKWELL, pp. 56-56.

Lovell, MR, Luckett, T, Boyle, FM, Phillips, J, Agar, M & Davidson, PM 2014, 'Patient Education, Coaching, and Self-Management for Cancer Pain', JOURNAL OF CLINICAL ONCOLOGY, vol. 32, no. 16, pp. 1712-+.
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Luckett, T, Davidson, PM, Boyle, F, Liauw, W, Agar, M, Green, A, Lovell, M, Care, IIP & Cooperative, PP 2014, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of oncologists', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 10, no. 2, pp. E99-E107.
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Keywords: Cancer, pain, guidelines

FOR Codes: Oncology and Carcinogenesis not elsewhere classified, Health Inequalities, Evaluation of Health Outcomes, Palliative Care, Health Education and Promotion, Cancer and Related Disorders, Treatment of human diseases and conditions

Acknowledgement of Country

UTS acknowledges the Gadigal people of the Eora Nation, the Boorooberongal people of the Dharug Nation, the Bidiagal people and the Gamaygal people, upon whose ancestral lands our university stands. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands.