Careers play a substantial role in managing cancer patients’ pain medicines at the end of life, however, current evidence suggests that they lack information and support and have concerns about pain medicines. In addition, interventions for carers have not been adequately developed or tested for effectiveness.
Lead researcher, Sue Latter, from the University of Southampton (UK), explained: “Despite the heavy burden placed on carers to help manage pain medication at home, there is a real lack of reliable research on effective methods of supporting carers with medicines management,” Latter commented.
“Medication management requires knowledge and practical skill, and involves carers in monitoring and interpreting symptoms, as well as selecting, administering and evaluating the effectiveness of medicines. Often, carers will not have training for their role and will have preconceived views about pain and analgesics, particularly opioids.”
A recent feasibility trial, published in Pallative Medicine, describes a complex intervention to support carers in managing medications at the end of life.
The two-arm, cluster randomized controlled feasibility trial evaluated the Cancer Carers Medicines Management, including a qualitative study to evaluate of Cancer Carers Medicines Management and trial procedures. The Phase I comprised 57 carers, patients and healthcare professionals and Phase II comprised 12 nurses and 15 carers.
Carers and nurses who took part concluded that the Cancer Carers Medicines Management was acceptable to carers and nurses and some benefits were identified. Overall, the feasibility trial has helped illuminate important design issues to be considered in future research. The researchers believe the intervention should be further investigated to evaluate its effect on outcomes in carers and patients.
Director of Nursing at Marie Curie, Dee Sissons, concluded: “The responsibility of taking on a caring role for someone who is terminally ill can be immensely rewarding, but also daunting. Family carers play a critical role in supporting people with a terminal illness so they can be cared for and die at home when this is their wish.”
Sources: Latter S, Hopkinson JB, Lowson E, et al. Supporting family caregivers to manage pain medication in cancer patients at end of life: a feasibility trial. Palliative Medicine DOI: 10.1177/0269216317715197 (2017); Science Daily press release