The University of Southampton
University of Southampton Institutional Repository

Supporting carers to manage pain medication in cancer patients at end of life: a feasibility trial

Supporting carers to manage pain medication in cancer patients at end of life: a feasibility trial
Supporting carers to manage pain medication in cancer patients at end of life: a feasibility trial
Background:

Carers of people with advanced cancer play a significant role in managing pain medication, yet they report insufficient information and support to do so confidently and competently. There is limited research evidence on the best ways for clinicians to help carers with medication management.

Aims:

To develop a pain medicines management intervention (Cancer Carers Medicines Management) for cancer patients’ carers near the end of life and evaluate feasibility and acceptability to nurses and carers. To test the feasibility of trial research procedures and to inform decisions concerning a full-scale randomised controlled trial.

Design:

Phase I-II clinical trial. A systematic, evidence-informed participatory method was used to develop CCMM: a nurse-delivered structured conversational process. A two-arm, cluster randomised controlled feasibility trial of Cancer Carers Medicines Management was conducted, with an embedded qualitative study to evaluate participants’ experiences of Cancer Carers Medicines Management and trial procedures.

Setting:

Community settings in two study sites.

Participants:

Phase I comprises 57 carers, patients and healthcare professionals and Phase II comprises 12 nurses and 15 carers.

Results:

A novel intervention was developed. Nurses were recruited and randomised. Carer recruitment to the trial was problematic with fewer than predicted eligible participants, and nurses judged a high proportion unsuitable to recruit into the study. Attrition rates following recruitment were typical for the study population. Cancer Carers Medicines Management was acceptable to carers and nurses who took part, and some benefits were identified.

Conclusion:

Cancer Carers Medicines Management is a robustly developed medicines management intervention which merits further research to test its effectiveness to improve carers’ management of pain medicines with patients at the end of life. The study highlighted aspects of trial design that need to be considered in future research.
0269-2163
1-11
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b
Hopkinson, Jane B.
0d49da6d-9779-4a72-a2ce-8349186529b6
Lowson, Elizabeth
5f1664ff-e3ad-46d1-b318-c89786a76404
Hughes, Jane A.
0d94140f-ca76-4ddb-ada8-79299b4b89b7
Hughes, Jacki
3edde8fa-ddf1-477b-b032-eee273acc0b1
Duke, Susan
f0dc024d-f940-4f43-b5f9-adab34833ce7
Anstey, Sally
2c4a2c66-7347-490c-8a57-a7ca8623ebaf
Bennett, Michael
b5976b37-b115-4044-9baa-df409c391b17
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Smith, Peter
68d1515a-f5cc-4b39-ae9c-b923b8c093cd
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b
Hopkinson, Jane B.
0d49da6d-9779-4a72-a2ce-8349186529b6
Lowson, Elizabeth
5f1664ff-e3ad-46d1-b318-c89786a76404
Hughes, Jane A.
0d94140f-ca76-4ddb-ada8-79299b4b89b7
Hughes, Jacki
3edde8fa-ddf1-477b-b032-eee273acc0b1
Duke, Susan
f0dc024d-f940-4f43-b5f9-adab34833ce7
Anstey, Sally
2c4a2c66-7347-490c-8a57-a7ca8623ebaf
Bennett, Michael
b5976b37-b115-4044-9baa-df409c391b17
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Smith, Peter
68d1515a-f5cc-4b39-ae9c-b923b8c093cd
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7

Latter, Sue, Hopkinson, Jane B., Lowson, Elizabeth, Hughes, Jane A., Hughes, Jacki, Duke, Susan, Anstey, Sally, Bennett, Michael, May, Carl, Smith, Peter and Richardson, Alison (2017) Supporting carers to manage pain medication in cancer patients at end of life: a feasibility trial. Palliative Medicine, 1-11. (doi:10.1177/0269216317715197).

Record type: Article

Abstract

Background:

Carers of people with advanced cancer play a significant role in managing pain medication, yet they report insufficient information and support to do so confidently and competently. There is limited research evidence on the best ways for clinicians to help carers with medication management.

Aims:

To develop a pain medicines management intervention (Cancer Carers Medicines Management) for cancer patients’ carers near the end of life and evaluate feasibility and acceptability to nurses and carers. To test the feasibility of trial research procedures and to inform decisions concerning a full-scale randomised controlled trial.

Design:

Phase I-II clinical trial. A systematic, evidence-informed participatory method was used to develop CCMM: a nurse-delivered structured conversational process. A two-arm, cluster randomised controlled feasibility trial of Cancer Carers Medicines Management was conducted, with an embedded qualitative study to evaluate participants’ experiences of Cancer Carers Medicines Management and trial procedures.

Setting:

Community settings in two study sites.

Participants:

Phase I comprises 57 carers, patients and healthcare professionals and Phase II comprises 12 nurses and 15 carers.

Results:

A novel intervention was developed. Nurses were recruited and randomised. Carer recruitment to the trial was problematic with fewer than predicted eligible participants, and nurses judged a high proportion unsuitable to recruit into the study. Attrition rates following recruitment were typical for the study population. Cancer Carers Medicines Management was acceptable to carers and nurses who took part, and some benefits were identified.

Conclusion:

Cancer Carers Medicines Management is a robustly developed medicines management intervention which merits further research to test its effectiveness to improve carers’ management of pain medicines with patients at the end of life. The study highlighted aspects of trial design that need to be considered in future research.

Text
CCMM Results paper Pall Medicine - Accepted Manuscript
Download (64kB)
Text
Appendix 1 - Accepted Manuscript
Download (74kB)
Text
Appendix 2 - Accepted Manuscript
Download (24kB)
Text
CCMM PM paper Appendix 3 - Accepted Manuscript
Download (46kB)
Text
CCMM PM paper Figure 1 CONSORT flow diagram - Accepted Manuscript
Download (71kB)
Text
CCMM Results PM paper Table 1 Components of Cancer Carers Medicines Management - Accepted Manuscript
Download (15kB)
Text
CCMM PM paper Table 2 303017 - Accepted Manuscript
Download (14kB)
Text
CCMM PM paper Table 3 clean copy - Accepted Manuscript
Download (15kB)
Text
CCMM PM paper Table 4 v2 - Accepted Manuscript
Download (13kB)
Text
CCMM PM paper Table 5 Factors influencing recruitment of study participants - Accepted Manuscript
Download (15kB)
Text
0269216317715197 - Version of Record
Available under License Creative Commons Attribution.
Download (865kB)

Show all 11 downloads.

More information

Accepted/In Press date: 23 May 2017
e-pub ahead of print date: 5 July 2017

Identifiers

Local EPrints ID: 412377
URI: http://eprints.soton.ac.uk/id/eprint/412377
ISSN: 0269-2163
PURE UUID: 8686cc40-f842-4247-a1ce-267ae12d7bf6
ORCID for Sue Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for Susan Duke: ORCID iD orcid.org/0000-0002-4058-8086
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

Catalogue record

Date deposited: 17 Jul 2017 13:33
Last modified: 07 Oct 2020 05:34

Export record

Altmetrics

Contributors

Author: Sue Latter ORCID iD
Author: Jane B. Hopkinson
Author: Elizabeth Lowson
Author: Jane A. Hughes
Author: Jacki Hughes
Author: Susan Duke ORCID iD
Author: Sally Anstey
Author: Michael Bennett
Author: Carl May ORCID iD
Author: Peter Smith

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×