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New nurse-led initiative helps carers manage cancer patients’ pain medication

Author: Leila Hawkins
07 July 2017

A new study funded by Marie Curie and Dimbleby Cancer Care shows the benefits of a new programme where nurses support carers to manage pain medication for people with terminal cancer.

Many people with advanced cancer experience persistent pain and are typically prescribed painkillers including opioids. While carers often help patients manage their pain medication, especially near the end of life, they often do not receive the support they need.

As a result researchers from the University of Southampton, Cardiff University and University of Leeds have developed the Cancer Carers’ Medicines Management (CCMM).  This is the first time a study has attempted to integrate a programme using input from carers and nurses into routine palliative care.

The research showed that CCMM offered a more comprehensive approach to supporting how carers manage pain medicines.  Nurses particularly valued the toolkit resource, which included information about opioids and simple charts for documenting pain and medication  that were of immediate practical value to carers.

The findings also identified some positive changes like a greater acceptance of the need for opiates, responding more readily to patients’ requests for pain relief, and improved systems for giving and recording medicines.

Commenting on the reasons for developing CCMM, Professor Sue Latter, the lead researcher from the University of Southampton, said: 

“Despite the heavy burden placed on carers to help manage pain medication at home, there is a real lack of reliable research on effective methods of supporting carers with medicines management.” 

“Medication management requires knowledge and practical skill, and involves carers in monitoring and interpreting symptoms, as well as selecting, administering and evaluating the effectiveness of medicines.  Often, carers will not have training for their role and will have preconceived views about pain and analgesics, particularly opioids.”

Dee Sissons, Director of Nursing at Marie Curie, said: 

“The responsibility of taking on a caring role for someone who is terminally ill can be immensely rewarding, but also daunting.  Family carers play a critical role in supporting people with a terminal illness so they can be cared for and die at home when this is their wish.” 

“This new study shows that nurses and carers can work together to better manage pain medication at home and enable carers to respond more readily to their loved ones request for pain relief with greater confidence.”

The nurses who participated in the study also provided feedback on how to use CCMM more widely in palliative care nursing.  Their suggestions included: involving patients with other terminal illnesses, including other ‘end of life care’ medication, and introducing it earlier in the course of a patient’s illness, which could increase benefits to carers.

Commenting in response, Marie Cooper, Practice Development Lead at Hospice UK, said:

“This study highlights the valuable contribution by nurses in supporting carers with pain medication management for their loved ones and we welcome its findings.

“Managing terminally ill people’s pain effectively at home, where most people prefer to be, is critical to their care and overall quality of life. Our recent report “No Painful Compromise” highlighted the barriers faced by many people in accessing effective pain relief at home, including insufficient staffing levels for some healthcare professionals supporting dying people.

“It is imperative that carers have access to the support they need to provide the care they wish for their loved ones.”

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