Randomized controlled study of pain education in patients receiving radiotherapy for painful bone metastases

Jenske I Geerling, Yvette M van der Linden, Natasja J H Raijmakers, Karin M Vermeulen, Ellen J M de Nijs, Paulien G Westhoff, Geertruida H de Bock, Alexander de Graeff, Anna K L Reyners*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Although short-course radiotherapy is an effective treatment for patients with painful bone metastases, pain is not always sufficiently controlled. We therefore investigated the additional effect of a nurse-led pain education program on pain control and quality of life (QoL). Patients and methods: In this multicenter study, patients with solid tumor bone metastases and a worst pain intensity of ≥5 on a 0–10 numeric rating scale (NRS) were randomized between care as usual (control-group) and care as usual plus the Pain Education Program (PEP-group). PEP consisted of a structured interview and personalized education with follow-up phone calls. Patients completed the Brief Pain Inventory, EORTC QLQ-C15-PAL and BM22 at week 0, 1, 4, 8 and 12. The primary outcome was pain control, defined as the number of patients whose worst pain intensity was <5 on a 0–10 NRS after 12 weeks. Secondary outcomes were time to reach control of pain (NRS < 5), mean worst pain and average pain, and QoL at weeks 1, 4, 8 and 12. Results: Of 308 included patients, 182 (92 PEP-group) completed 12 weeks follow-up. At 12 weeks, more patients in the PEP-group (71%) compared to the control-group (52%) reported pain control (P =.008). In the PEP-group, pain control was reached earlier than in the control-group (median 29 days versus 56 days; P =.003). Mean worst and average pain decreased in both groups but decreased more in the PEP-group. QoL did not differ between the groups. Conclusion: The addition of PEP to care as usual for patients treated with radiotherapy for painful bone metastases resulted in less pain and faster pain control.

Original languageEnglish
Article number109687
JournalRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume185
Early online date9 May 2023
DOIs
Publication statusPublished - Aug 2023

Keywords

  • Bone metastases
  • Pain education program
  • Radiotherapy

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