Results Summary

What was the research about?

Hospice care aims to keep patients comfortable and reduce their pain in the last weeks or months of life. In this study, the research team wanted to reduce pain for patients with cancer in hospice care. The team created PAINRelieveIt, a software program for patients and their caregivers to use on a tablet. Caregivers are family members or friends who help a patient on a regular basis.

The PAINRelieveIt program had three parts:

  • Patients entered information about their pain and pain medicine.
  • Patients and caregivers got information about how to manage pain.
  • Nurses reviewed patients’ entries to help manage patients’ pain.

The research team compared patients who used PAINRelieveIt as part of hospice care with patients who got regular hospice care only.

What were the results?

The study found no differences between patients who used PAINRelieveIt and patients who got regular hospice care in

  • How often patients took their pain medicine as prescribed
  • How well patients understood how to manage pain
  • How satisfied patients were with their pain levels

Caregivers who used PAINRelieveIt understood more about how to manage pain than caregivers who didn’t use the program.

Who was in the study?

The study included 234 patients with cancer getting care at home from two hospice services in Chicago. The research team expected all patients to live at least 10 days. Among patients, 49 percent were white, 35 percent were black, 14 percent were another race, and 18 percent were Hispanic. Patients’ average age was 68, and 51 percent were women.

The study also included 231 caregivers of patients in the study. The average age of caregivers was 53, and 74 percent were women. Among caregivers, 44 percent were white, 36 percent were black, 12 percent were another race, and 20 percent were Hispanic.

What did the research team do?

The research team assigned patients by chance to get either usual hospice care or hospice care plus the PAINRelieveIt program. All patients had a tablet computer. They used the tablets to record information about their pain and pain medicine each day for six days.

Patients in the PAINRelieveIt group and their caregivers could also learn how to manage pain on their tablet. Patients in the usual care group could play games on their tablet.

Before and after the study, patients filled out surveys about their pain, and patients and caregivers filled out surveys about how to manage pain.

What were the limits of the study?

Because of changes to how the research team asked patients to take part in the study, more patients ended up getting usual hospice care than PAINRelieveIt. Results may differ in a study with similar numbers of patients in each study group. Nurses didn’t always have access to patients’ pain reports. This may have affected how they managed pain.

Future research could continue to look at ways to help patients in hospice care manage pain.

How can people use the results?

People who work in hospice care may use these results when deciding how to help patients and caregivers manage pain.

Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • Reviewers asked for additional information on how researchers handled comorbid conditions in this study. The researchers responded that because they assumed that all hospice patients would have many comorbidities, they did not control for these comorbidities in their analyses.
  • Reviewers noted that the report’s background did not discuss the psychosocial, sociopolitical and sociomoral components of pain experience. The researchers responded that they did address these but used different language that referred instead to the patient and physician barriers to adequately assessing pain.
  • Reviewers lauded the researchers’ 20-year history of engaging patients and stakeholders in research but requested more specificity about the patient and stakeholder engagement activities that influenced this study. The researchers provided additional detail about the engagement activities that were part of and contributed to this study.
  • Reviewers noted that the seven- to nine-day assessment period was unlikely to be long enough to get good control over neuropathic pain and could explain the lack of significant impact of the intervention. The researchers acknowledged that the study period was brief but explained that this was the result of the short, median hospice stay of 19 days.

Conflict of Interest Disclosures

Project Information

Robert E. Molokie, MD^
University of Illinois at Chicago
$1,706,062
10.25302/8.2019.IH.13046553
Computerized PAINRelieveIt Protocol for Cancer Pain Control in Hospice

Key Dates

September 2013
July 2018
2013
2018

Study Registration Information

^Diana J. Wilkie, PhD, MS, BSN, was the original principal investigator for this project.

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Last updated: January 25, 2023