Researchers from the University of Leeds have found that many people with terminal cancer are failing to receive adequate pain relief in time to control their discomfort. The findings showed that, on average, the first dose of a strong opioid was prescribed 9 weeks before death, despite moderate to severe pain frequently being present much earlier.
The research, published in the journal Pain, used a sample of over 6,000 patients who died between 2005 and 2012 and found that 48% of the patients were issued a strong opioid during their last year of life. The study also showed that people with cancer over the age of 60 were likely to be prescribed analgesia later than younger people and that those receiving hospice care were more likely to receive analgesia at an earlier stage.
With effective analgesia in end of life care still clearly not always being used effectively, read on to learn more about how you can ensure your own residents receive the pain relief they need at the end of life.
Lead researcher, Dr Lucy Ziegler, of the Leeds Institute for Health Sciences said ‘We have identified for the first time the relatively late onset and short duration of strong opioid treatment in cancer patients prior to death. Although the prevalence of pain is higher in patients with advanced cancer and towards the end of life, for many patients, pain is experienced at many stages throughout the illness.’
Dr Ziegler went on to state ‘Our research highlights the need to prioritise earlier access to effective pain management for patients with advanced cancer. Effective pain control is fundamental to good quality of life and it is crucially important we strive to get this right and that we help them achieve the best quality of life possible.’
4 Steps to Effective End of Life Pain Relief
- Assess pain fully before treatment. Pain should always be assessed before regular analgesia is commenced. Remember to ask for a description of the pain and if the person has more than one pain, assess each pain individually to identify possible causes.
- Consider reversible causes. Pain may be due to easily reversible causes, such as poor positioning or constipation. Always identify if practical steps can be taken to relieve pain which may provide relief more quickly and with fewer potential complications than analgesia.
- Ask the person regularly about their pain. Ensure that your team enquire regularly about the person’s experience of pain and the effectiveness of the measures you are taking. People often under-report pain for fear of being seen as a nuisance, so actively enquiring about their pain level will help elicit the information you need.
- Record pain scores. Use a pain assessment tool, such as the Abbey Pain Scale, to provide an ongoing record of the level of pain experienced by the person and the effectiveness of your measures.