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P-141 The pain management group: an MDT approach to pain management in palliative care
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  1. Elizabeth Nicholls,
  2. Sarah Fielder and
  3. Harriet Bush
  1. Countess Mountbatten Hospice, Southampton, UK

Abstract

Background During multi-disciplinary (MDT) patients’ meetings, pain management was regularly discussed. Pain was often described as complex and focussed on the pharmaceutical approach, however, it was often noticed that this was not improving a patient’s quality of life. Literature highlights the importance of a holistic and MDT approach to pain management (Fielding, Sanford & Davis, 2013; Phillips, Lovell, Luckett, Agar et al., 2015), but there was little evidence of this in practice except for occasional discussions about exercise. An alternative MDT approach was needed to meet patients’ needs and improve quality of life.

Aim To improve patients’ management of pain and improve quality of life through an educative programme led by the MDT, with additional support to carers by improving knowledge and teaching management strategies.

Method The five-week out-patient group was developed by a palliative care Consultant, Clinical Nurse Specialist and Occupational Therapist. Each week involved reflection, goal setting, education, exercise and relaxation. Education topics included: What is pain? Understanding medication, Emotional and spiritual pain, Sleep management and The Pain Survival Kit. Outcome measures were used (IPOS, Brief Pain inventory and AKPS). A feedback questionnaire was used for feedback at the end of the five weeks.

Results The outcome measures indicated an improvement in pain, physical abilities, enjoyment of life, relationships and reduced anxieties. Feedback questionnaires reported that patients felt empowered in managing pain especially due to improved understanding. Patients did not require as intensive support from other hospice services.

Conclusions The pain management group improved patients’ understanding of pain, medications and sleep, whilst also teaching strategies to increase their control over their pain, enabling a fuller life. The group also produced a reduction in the dependency on health care professionals and hospice services. The group provides an additional treatment option for patients with complex symptoms of total pain.

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