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systemic review notes

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Adam 2016
29 reports from 22 trials of 20 interventions. PROM measures were used to alert physicians to poorly controlled pain, target
paine ducation and link treatment to management algorithms.
Conclusion: feedback of PROM data tended to increase discussions b/w patients and progessionals about pain and/or
symptoms overall.
Communication
How measured?
What were the results?
Biblio
Outcome
Guideline adherance
Deviations from
Droney J, Riley J.
principles of good
Bertsche, et al.,
pain therapy
multidisciplinary pain
according to
management based on
international and
a computerized clinical
national guidelines –
decision support
comparison on
system in cancer pain
admission and at
patients. Pain.
discharge
2009;147(1-3):1-2.
Prescription of
medications
Reporting of
symptoms
Health Outcomes
Pain intensity
MD anderso symptom
inventory (MDASI) cancer related sx over
the previous 24 hours
+ how much sx
interfered with
common functional
domains. IVR
generated alerts to
inform pt team when
symptom threshold
was reached. Sx and
threshold decided by
thoracotomy team.
Symptom threshold
events were
recorded. Patient
called 2x/week for 4
weeks. Doctors added
in chart if they
responded to
thresholds and what
specific actions were
taken. Final
assessment at follow
up clinic to get
patietns perception.
Interventions were associated with more
symptoms being reported and/or more
discussions specifically about pain
Cleeland CS, Wang XS,
Shi Q, et al. Automated
symptom alerts reduce
postoperative
symptom severity after
cancer surgery: a
randomized controlled
clinical trial. J Clin
Oncol. 2011;29(8):9941000.
Visual Analogue Scale
Numerical pain
ratings
Brief Pain inventory
Amsterdam Pain
Management Index
Statistically significant reduction in average
pain intensity was found.
Mention citations from
picture
Alsaleh
Health outcomes
Physical symptoms
burden
Communication
effects
Patient-provider
communication
Oncologists
randomized to
receive findings of
completed
questionnaires or
not to receive. 510
pts. Self rated pain
at baseline and
then 4 weeks later.
Improvement in pain rating and
increase in analgesic was measured.
Trowbridge R, Dugan W,
Jay SJ, et al. Determining
the effectiveness of a
clinical-practice
intervention in improving
the control of pain in
outpatients with
cancer. Acad Med.
1997;72(9):798-800.
DETMAR ET AL:
Randomized cross
over trial. 10. 214
pts. Half receive
results of EORTC
QLQ-C30 scale
(PRO) and half
conventional way
without PRO.
Washout period
and crossed over.
Detmar: better composite score on
evaluation checklist
Velikova: QoL scores were better in
intervention than control (emotional
well being)
Detmar SB, Muller MJ,
Schornagel JH, Wever LD,
Aaronson NK. Healthrelated quality-of-life
assessments and patientphysician
communication: a
randomized controlled
trial [published
correction appears in
JAMA. 2003 Feb
26;289(8):987.]. JAMA.
2002;288(23):3027-3034.
VELIKOVA ET AL: 3
arms. EORTC QLQ
arm with feedback
to physicians,
EORTC QLQ arm
without feedback
to physicians, no
questionnaire arm.
Primary outcome
was QoL and FACTG
Patient and
Clinician
awareness of QOL
Detmar RCT ^
Better physician awareness of patients
QoL as assessed by agreement b/w
physicians and patients rating of
symptoms on the Dartmouth Primary
Care Cooperative Information
Velikova G, Booth L,
Smith AB, et al.
Measuring quality of life
in routine oncology
practice improves
communication and
patient well-being: a
randomized controlled
trial. J Clin Oncol.
2004;22(4):714-724.
Detmar SB, Muller MJ,
Schornagel JH, Wever LD,
Aaronson NK. Healthrelated quality-of-life
assessments and patient-
Functional Health Assessment (COOP)
and the World Organisation Project of
National Colleges and Academics
(WONCA) charts
Chen 2013
Health outcomes
Monitoring of
treatment response
Positive impact of
health outcomes –
13/15 studies
Communication
effects
Patient-provider
communication
Detecting
unrecognized
problems
Changes to patient
management
Etkind 2015
Health outcomes
Improved
psychological and
emotional QOL
Patient and Clinician
awareness and
involvement
Communication
outcomes
Reporting of
symptoms
Patient-provider
communication
Changes to patient
management
Howell
Health Outcomes
physician
communication: a
randomized controlled
trial [published
correction appears in
JAMA. 2003 Feb
26;289(8):987.]. JAMA.
2002;288(23):3027-3034.
Helath realted QOL
Early detection and
monitoring of
symptoms
Communication
effects
Patient-provider
communication
Increased referral to
psychosocial care
Consultation time
Kotronoulas
Health Outcomes
Physical symptom
burden
Communication
effects
Timing of referrals
Discussion prompts
Yang 2018
Health Outcomes
Patient and Clinician
awareness and
involvement
Physical symptom
burden
Communication
effects
Timing of referrals
Interprofessional
communication
Discussion prompts
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