Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T13:57:38.042Z Has data issue: false hasContentIssue false
  • English
  • Français

Patient-reported quality of care and pain severity in cancer

Published online by Cambridge University Press:  26 June 2014

Kathryn A. Martinez ,
Claire F. Snyder ,
Jennifer L. Malin  and
Sydney M. Dy
Kathryn A. Martinez*
Affiliation:
VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan
Claire F. Snyder
Affiliation:
Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland
Jennifer L. Malin
Affiliation:
WellPoint, Thousand Oaks, California
Sydney M. Dy
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, Maryland
*
Address correspondence and reprint requests to Kathryn A. Martinez, VA Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, Building 16, 4th Floor, Ann Arbor, Michigan 48105. E-mail: makathry@med.umich.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients.

Method:

Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity.

Results:

The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006).

Significance of results:

Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.

Keywords

Cancer painQuality of carePatient satisfactionPain managementPatient-reported outcomes
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 875 - 884
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alazri, M.H. & Neal, R.D. (2003). The association between satisfaction with services provided in primary care and outcomes in type 2 diabetes mellitus. Diabetic Medicine, 20(6), 486–490.CrossRefGoogle ScholarPubMed
Anderson, K.O., Richman, S.P., Hurley, J., et al. (2002). Cancer pain management among underserved minority outpatients: Perceived needs and barriers to optimal control. Cancer, 94(8), 2295–2304.Google Scholar
Antón, A., Montalar, J., Carulla, J., et al. (2012). Pain in clinical oncology: Patient satisfaction with management of cancer pain. European Journal of Pain (London, England), 16(3), 381–389.Google Scholar
Avery, K.N.L., Metcalfe, C., Nicklin, J., et al. (2006). Satisfaction with care: An independent outcome measure in surgical oncology. Annals of Surgical Oncology, 13(6), 817–822.CrossRefGoogle ScholarPubMed
Ayanian, J.Z., Zaslavsky, A.M., Guadagnoli, E., et al. (2005). Patients' perceptions of quality of care for colorectal cancer by race, ethnicity, and language. Journal of Clinical Oncology, 23(27), 6576–6586.Google Scholar
Ayanian, J.Z., Zaslavsky, A.M., Arora, N.K., et al. (2010). Patients' experiences with care for lung cancer and colorectal cancer: Findings from the Cancer Care Outcomes Research and Surveillance Consortium. Journal of Clinical Oncology, 28(27), 4154–4161.CrossRefGoogle ScholarPubMed
Beck, S.L., Towsley, G.L., Berry, P.H., et al. (2010). Core aspects of satisfaction with pain management: Cancer patients' perspectives. Journal of Pain and Symptom Management, 39(1), 100–115.Google Scholar
Catalano, P.J., Ayanian, J.Z., Weeks, J.C., et al. (2013). Representativeness of participants in the cancer care outcomes research and surveillance consortium relative to the surveillance, epidemiology, and end results program. Medical Care, 51(2), e9–15.Google Scholar
Cintron, A. & Morrison, R.S. (2006). Pain and ethnicity in the United States: A systematic review. Journal of Palliative Medicine, 9(6), 1454–1473.Google Scholar
Cleeland, C.S. & Ryan, K.M. (1994). Pain assessment: Global use of the Brief Pain Inventory. Annals of the Academy of Medicine, Singapore, 23(2), 129–138.Google Scholar
Dang, B.N., Westbrook, R.A., Black, W.C., et al. (2013). Examining the link between patient satisfaction and adherence to HIV care: A structural equation model. PloS One, 8(1), e54729.Google Scholar
Dawson, R., Spross, J.A., Jablonski, E.S., et al. (2002). Probing the paradox of patients' satisfaction with inadequate pain management. Journal of Pain and Symptom Management, 23(3), 211–220.CrossRefGoogle ScholarPubMed
Deandrea, S., Montanari, M., Moja, L., et al. (2008). Prevalence of undertreatment in cancer pain: A review of published literature. Annals of Oncology, 19(12), 1985–1991.CrossRefGoogle ScholarPubMed
Dennison, C.R. (2002). The role of patient-reported outcomes in evaluating the quality of oncology care. The American Journal of Managed Care, 8(18 Suppl.), S580–S586.Google Scholar
Fairchild, A. (2010). Under-treatment of cancer pain. Current Opinion in Supportive and Palliative Care, 4(1), 11–15.Google Scholar
Fenton, J.J., Jerant, A.F., Bertakis, K.D., et al. (2012). The cost of satisfaction: A national study of patient satisfaction, health care utilization, expenditures, and mortality. Archives of Internal Medicine, 172(5), 405–411.Google Scholar
Fisch, M.J., Lee, J.-W., Weiss, M., et al. (2012). Prospective, observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. Journal of Clinical Oncology, 30(16), 1980–1988.Google Scholar
Fremont, A.M., Cleary, P.D., Hargraves, J.L., et al. (2001). Patient-centered processes of care and long-term outcomes of myocardial infarction. Journal of General Internal Medicine, 16(12), 800–808.Google Scholar
Gan, T.J., Lubarsky, D.A., Flood, E.M., et al. (2004). Patient preferences for acute pain treatment. British Journal of Anaesthesia, 92(5), 681–688.Google Scholar
Groene, O. (2011). Patient centredness and quality improvement efforts in hospitals: Rationale, measurement, implementation. International Journal for Quality in Health Care, 23(5), 531–537.Google Scholar
Isaac, T., Zaslavsky, A.M., Cleary, P.D., et al. (2010). The relationship between patients' perception of care and measures of hospital quality and safety. Health Services Research, 45(4), 1024–1040.Google Scholar
Jerant, A., Fenton, J.J., Bertakis, K.D., et al. (2014). Satisfaction with health care providers and preventive care adherence: A national study. Medical Care, 52(1), 78–85.CrossRefGoogle ScholarPubMed
Kroenke, K., Wu, J., Bair, M.J., et al. (2011). Reciprocal relationship between pain and depression: A 12-month longitudinal analysis in primary care. The Journal of Pain, 12(9), 964–973.Google Scholar
Luckett, T., Davidson, P.M., Green, A., et al. (2013). Assessment and management of adult cancer pain: A systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. Journal of Pain and Symptom Management, 46(2), 229–253.Google Scholar
Malin, J.L., Ko, C., Ayanian, J.Z., et al. (2006). Understanding cancer patients' experience and outcomes: Development and pilot study of the Cancer Care Outcomes Research and Surveillance patient survey. Supportive Care in Cancer, 14(8), 837–848.Google Scholar
McCracken, L.M., Klock, P.A., Mingay, D.J., et al. (1997). Assessment of satisfaction with treatment for chronic pain. Journal of Pain and Symptom Management, 14(5), 292–299.Google Scholar
McNeill, J.A., Sherwood, G.D. & Starck, P.L. (2004). The hidden error of mismanaged pain: A systems approach. Journal of Pain and Symptom Management, 28(1), 47–58.Google Scholar
Miaskowski, C., Nichols, R., Brody, R., et al. (1994). Assessment of patient satisfaction utilizing the American Pain Society's Quality Assurance Standards on acute and cancer-related pain. Journal of Pain and Symptom Management, 9(1), 5–11.Google Scholar
National Research Council (2013). Delivering high-quality cancer care: Charting a new course for a system in crisis. Washington, DC: The National Academies Press.Google Scholar
Naveh, P., Leshem, R., Dror, Y.F., et al. (2011). Pain severity, satisfaction with pain management, and patient-related barriers to pain management in patients with cancer in Israel. Oncology Nursing Forum, 38(4), E305–E313.Google Scholar
Norman, G.R., Sloan, J.A. & Wyrwich, K.W. (2003). Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.Google Scholar
Panteli, V. & Patistea, E. (2007). Assessing patients' satisfaction and intensity of pain as outcomes in the management of cancer-related pain. European Journal of Oncology Nursing, 11(5), 424–533.Google Scholar
Rahim-Williams, B., Riley, J.L., Williams, A.K.K., et al. (2012). A quantitative review of ethnic group differences in experimental pain response: Do biology, psychology, and culture matter? Pain Medicine (Malden, Massachusetts), 13(4), 522–540.CrossRefGoogle ScholarPubMed
Safran, D.G., Taira, D.A., Rogers, W.H., et al. (1998). Linking primary care performance to outcomes of care. The Journal of Family Practice, 47(3), 213–220.Google Scholar
Salaffi, F., Stancati, A., Silvestri, C.A., et al. (2004). Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. European Journal of Pain (London, England), 8(4), 283–291.Google Scholar
Siegel, R., Ma, J., Zou, Z., et al. (2014). Cancer statistics, 2014. CA: A Cancer Journal for Clinicians, 64(1), 9–29.Google Scholar
StataCorp (2013). Stata statistical software: Release 13. College Station, TX: StataCorp.Google Scholar
Tavoli, A., Montazeri, A., Roshan, R., et al. (2008). Depression and quality of life in cancer patients with and without pain: The role of pain beliefs. BMC Cancer, 8, 177.Google Scholar
Turvey, C.L., Wallace, R.B. & Herzog, R. (1999). A revised CES–D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics/IPA, 11(2), 139–148.Google Scholar
van den Beuken-van Everdingen, M.H.J., de Rijke, J. M., Kessels, A.G., et al. (2007). Prevalence of pain in patients with cancer: A systematic review of the past 40 years. Annals of Oncology, 18(9), 1437–1449.Google Scholar
von Gruenigen, V.E., Hutchins, J.R., Reidy, A.M., et al. (2006). Gynecologic oncology patients' satisfaction and symptom severity during palliative chemotherapy. Health and Quality of Life Outcomes, 4, 84.Google Scholar
Wagner-Johnston, N.D., Carson, K.A. & Grossman, S.A. (2010). High outpatient pain intensity scores predict impending hospital admissions in patients with cancer. Journal of Pain and Symptom Management, 39(2), 180–185.Google Scholar
Ward, S.E. & Gordon, D. (1994). Application of the American Pain Society quality assurance standards. Pain, 56(3), 299–306.CrossRefGoogle ScholarPubMed
Yates, P.M., Edwards, H.E., Nash, R.E., et al. (2002). Barriers to effective cancer pain management: A survey of hospitalized cancer patients in Australia. Journal of Pain and Symptom Management, 23(5), 393–405.Google Scholar