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Patient-reported quality of care and pain severity in cancer

Published online by Cambridge University Press:  26 June 2014

Kathryn A. Martinez ,
Claire F. Snyder ,
Jennifer L. Malin  and
Sydney M. Dy
Kathryn A. Martinez*
Affiliation:
VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan
Claire F. Snyder
Affiliation:
Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, Maryland
Jennifer L. Malin
Affiliation:
WellPoint, Thousand Oaks, California
Sydney M. Dy
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, Maryland
*
Address correspondence and reprint requests to Kathryn A. Martinez, VA Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, Building 16, 4th Floor, Ann Arbor, Michigan 48105. E-mail: makathry@med.umich.edu.
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Abstract

Objective:

Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients.

Method:

Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity.

Results:

The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006).

Significance of results:

Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.

Keywords

Cancer painQuality of carePatient satisfactionPain managementPatient-reported outcomes
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 875 - 884
Copyright
Copyright © Cambridge University Press 2014 

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