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Robert Swarm, Amy Pickar Abernethy, Doralina L. Anghelescu, Costantino Benedetti, Craig D. Blinderman, Barry Boston, Charles Cleeland, Nessa Coyle, Oscar A. deLeon-Casasola, June G. Eilers, Betty Ferrell, Nora A. Janjan, Sloan Beth Karver, Michael H. Levy, Maureen Lynch, Natalie Moryl, Barbara A. Murphy, Suzanne A. Nesbit, Linda Oakes, Eugenie A. Obbens, Judith A. Paice, Michael W. Rabow, Karen L. Syrjala, Susan Urba, and Sharon M. Weinstein

. A formal comprehensive pain assessment must be performed. Reassessment of pain intensity must be performed at specified intervals to ensure that the therapy selected is having the desired effect. Psychosocial support must be available. Specific

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Robert A. Swarm

patients at each contact. Patients who report pain must undergo a comprehensive pain assessment to determine pain etiology, pathophysiology and severity, and the patient’s goals for function and comfort ( Figure 1 ). “The patient’s own report of pain, the

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Judith A. Paice

. Basics of Pain Assessment “Pain is not just a change in the nervous system, there are deeply held beliefs and meanings associated with the individual's pain,” revealed Dr. Paice. The basics of assessing pain include its onset, location, duration

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Robert A. Swarm, Amy Pickar Abernethy, Doralina L. Anghelescu, Costantino Benedetti, Sorin Buga, Charles Cleeland, Oscar A. deLeon-Casasola, June G. Eilers, Betty Ferrell, Mark Green, Nora A. Janjan, Mihir M. Kamdar, Michael H. Levy, Maureen Lynch, Rachel M. McDowell, Natalie Moryl, Suzanne A. Nesbit, Judith A. Paice, Michael W. Rabow, Karen L. Syrjala, Susan G. Urba, Sharon M. Weinstein, Mary Dwyer, and Rashmi Kumar

assessing and treating cancer pain. 6 - 8 This requires familiarity with the pathogenesis of cancer pain; pain assessment techniques; common barriers to the delivery of appropriate analgesia; and pertinent pharmacologic, anesthetic, neurosurgical

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Rehab Abdelwahab, Anas Hamad, Shereen El Azzaz, Randa Al Okka, Mohd A. Wahid, Khalil Ullah Shibli, Ahmed El Geziry, Fathi Saleh, Kakil Rasul, and Wael Saleem

determine the efficiency of the referral pathway to the pain clinic by PMT. Methods: PMT is going to assess the referred patient to their clinics according to pain assessment methods. Patients will be evaluated whether they have been appropriately referred

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Robert A. Swarm, Judith A. Paice, Doralina L. Anghelescu, Madhuri Are, Justine Yang Bruce, Sorin Buga, Marcin Chwistek, Charles Cleeland, David Craig, Ellin Gafford, Heather Greenlee, Eric Hansen, Arif H. Kamal, Mihir M. Kamdar, Susan LeGrand, Sean Mackey, M. Rachel McDowell, Natalie Moryl, Lisle M. Nabell, Suzanne Nesbit, BCPS, Nina O’Connor, Michael W. Rabow, Elizabeth Rickerson, Rebecca Shatsky, Jill Sindt, Susan G. Urba, Jeanie M. Youngwerth, Lydia J. Hammond, and Lisa A. Gurski

taking (addiction-related outcomes) Affect: relationship between pain and mood The importance of relieving pain and the availability of effective therapies make it imperative that health care providers be adept at cancer pain assessment and treatment. 13

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Sharon M. Weinstein, Dorothy Romanus, Eva M. Lepisto, Cielito Reyes-Gibby, Charles Cleeland, Rex Greene, Cameron Muir, and Joyce Niland

The National Comprehensive Cancer Network (NCCN), an organization of 19 of the world's leading cancer centers, developed and communicated a cancer pain treatment guideline. NCCN seeks to implement guidelines through performance measurement using a NCCN Oncology Outcomes Database. This is a preliminary report from the NCCN Cancer Pain Management Database Project. The primary objective of this NCCN Cancer Pain Management Database Project study is to evaluate the frequency, methods, and extent of documentation of cancer pain assessment and managementat NCCN institutions. A pain data dictionary and related data collection forms were first developed. The records of 209 breast cancer patients with bone metastases were then studied. The frequency of pain mentions, type of pain assessment tool used, pain characteristics, type of clinician documenting pain, location in the medical record, and pain treatment characteristics were noted. The majority of clinical encounters included pain mentions, although considerable variability was found in pain documentation between providers and between inpatient and outpatient settings. Nurses more frequently recorded pain, usually as a numeric pain intensity score. Pain specialists were more likely to record a complete description of pain. A significant minority of patients experienced moderate to severe pain. In a small subgroup of patients with moderate to severe pain, pain treatment was not recorded. The undertreatment of cancer pain has been a focus of investigation and review for the past two decades. Quality improvement efforts to raise the standard of pain management have been underway. The results of this study highlight the need for standardization of pain documentation in comprehensive cancer centers as a prerequisite for the proper assessment of cancer pain and the improvement of clinical outcomes of pain management.

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symptom pain control and that pain management contributes to quality-of-life improvement. To maximize patient outcomes, pain management is an essential part of oncologic management.” 4th bullet was modified as: “Comprehensive pain assessment must be

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Lon Hays, Kenneth L. Kirsh, and Steven D. Passik

Miller-McCoulry V . Patient-related barriers to management of cancer pain . Pain 1993 ; 52 : 319 – 324 . 13 Ramer L Richardson JL Cohen MZ . Multimeasure pain assessment in an ethnically diverse group of patients with cancer . J

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Stephanie J. Lee

: DeVita VT Hellman S Rosenberg SA , eds. Cancer: Principles and Practice of Oncology , vol 2 , 5th ed . Philadelphia, PA : Lippincott-Raven Publishers ; 1997 : 2344 – 2387 . 15 Cleeland CS Ryan KM . Pain assessment: global use of the