Background & Aims

Chronic pain, defined as “persistent or recurrent pain lasting longer than 3 months”, [1] is a debilitating symptom that significantly impacts the quality of life for many people. [2] Among people with cancer, the prevalence of chronic pain has been estimated at 30% to 50% in patients undergoing cancer treatment and more than 70% in patients with advanced or terminal cancer. [3,4] The proposed large-scale, mixed-methods survey study will compare the perceived benefits of Complementary and Integrative Medicine (CIM) therapies for Chronic Cancer Pain (CCP) among a national Canadian sample of individuals with cancer. We will obtain a comprehensive assessment of the effectiveness and safety of various CIM modalities for CCP. Specifically, the aims of our study are:
1. To investigate the types CIM therapies used for mitigating CCP and compare their perceived effectiveness.
2. To understand patient preferences regarding the use of CIM therapies for CCP management.

Methods

We will use a concurrent mixed methods design to compare how individuals with cancer in Canada perceive the effectiveness of CIM therapies for CCP. To collect quantitative data, we will conduct a cross-sectional survey study in which participants will be asked a series of questions examining their current and previous use of CIM modalities, how these modalities have affected the intensity of their CCP and interference with daily activities. At the end of the survey, participants will have the opportunity to express their interest in participating in a more detailed qualitative interview, which will explore their perceptions regarding the use of CIM therapies for CCP management. The qualitative part of the study will utilize interpretive descriptive methodology [5]. Overall, this mixed-methods approach will offer real-time information on the nuanced differences between various CIM modalities in relation to CCP.

Results

Based on a power analysis, the proposed study will include a sample size of 400 adult cancer patients and survivors in Canada. We will survey individuals with CCP across diverse demographic and clinical backgrounds and calculate the proportion of individuals using each type of CIM therapy. This information will help us understand which CIM modalities are most commonly used and can aid in prioritizing future research on these therapies. Using both quantitative and qualitative measures, we will examine individuals’ reported experiences of relief from CPP and improvements in related distress, as well as the impact on their daily functioning. We will compare CCP-related outcomes across different CIM modalities and consider them in the context of participant characteristics and treatment regimens. Through qualitative interviews, we will understand why individuals with cancer choose certain CIM therapies for CCP and why others are not used.

Conclusions

The proposed study is critically important, as evaluating the relative effectiveness and safety of the numerous CIM therapies available for CCP treatment poses significant challenges within the practical and ethical constraints of experimental research. Previous clinical trials have mainly focused on comparing a single CIM therapy against standard care, limiting our understanding of their comparative advantages. This lack of comprehensive knowledge hinders clinical decision-making regarding the selection of CIM therapies for CCP and strategic research investments in the CIM modalities that are most promising for CCP management. By identifying the most effective CIM treatments for CCP, the proposed study aims to bridge this knowledge gap. Additionally, our findings will illuminate the barriers and facilitators to the use of CIM for CCP in this population and may identify strategies to improve access and utilization.

References

1. Working together for pain relief throughout the world. International Association for the Study of Pain. URL: https://www. iasp-pain.org/ [accessed 2020-09-02]
2. van den Beuken-van Everdingen MH, Hochstenbach LM, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manage 2016 Jun;51(6):1070-1090.e9 [FREE Full text] [doi: 10.1016/j.jpainsymman.2015.12.340] [Medline: 27112310]
3. Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, et al. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 2009 Aug;20(8):1420-1433 [doi: 10.1093/annonc/mdp001] [Medline: 19244085]
4. Lam DK. Emerging factors in the progression of cancer-related pain. Pain Manag 2016 Oct;6(5):487-496. [doi: 10.2217/pmt-2015-0003] [Medline: 27150228]
5. Bradshaw C, Atkinson S, Doody O. Employing a Qualitative Description Approach in Health Care Research. Glob Qual Nurs Res. 2017;4:2333393617742282. Published 2017 Nov 24. doi:10.1177/2333393617742282 14

Presenting Author

Mohamad Baydoun

Poster Authors

Mohamad Baydoun

PhD

University of Regina

Lead Author

Topics

  • Treatment/Management: Complementary and Alternative therapies