The effect of a translating research into practice (trip)-cancer intervention on cancer pain management in older adults in hospice
Pain Medicine, 07/16/2012
Herr K et al. – Findings indicate a number of factors that may impact implementation of multicomponent interventions, including unique characteristics and culture of the setting, the level of involvement with the change processes, competing priorities and confounding factors, and complexity of the innovation (practice change). These results suggest that future study is needed on specific factors to target when implementing a community–based hospice intervention, including determining and measuring intervention fidelity prospectively.Methods
- This Institutional Human Subjects Review Board–approved study was a cluster randomized controlled trial implemented in 16 Midwestern hospices.
- Retrospective medical records from newly admitted patients were used to determine the intervention effect.
- Additionally, survey and focus group data gathered from hospice staff at the completion of the intervention phase were analyzed.
- Improvement on the Cancer Pain Practice Index, an overall composite outcome measure of evidence–based practices for the experimental sites, was not significantly greater than control sites.
- Decrease in patient pain severity from baseline to post–intervention in the experimental group was greater; however, the result was not statistically significant (P = 0.1032).