Impact of Case Conferencing on Pain in Patients with Chronic Diseases
Author Information
Author(s): Tina Mallon, Josefine Schulze, Nadine Pohontsch, Thomas Asendorf, Jan Weber, Silke Böttcher, Uta Sekanina, Franziska Schade, Nils Schneider, Judith Dams, Michael Freitag, Christiane Müller, Friedemann Nauck, Tim Friede, Martin Scherer, Gabriella Marx
Primary Institution: University Medical Center Hamburg-Eppendorf
Hypothesis
Can timely case conferencing between general practitioners and specialist palliative care services reduce symptom burden and pain in patients with advanced chronic diseases?
Conclusion
The intervention showed promise in improving pain management for patients with dementia, but did not significantly reduce symptom burden or pain in other groups.
Supporting Evidence
- Patients with dementia showed a significant pain reduction with a p-value of 0.009.
- The intervention did not significantly affect symptom burden in patients with COPD or CHF.
- Timely case conferencing may improve pain management in dementia patients.
- Challenges during the study included recruitment difficulties due to the COVID-19 pandemic.
- Imbalances in baseline characteristics may affect the study's results.
Takeaway
This study looked at whether meetings between doctors can help patients with serious illnesses feel less pain. It found that while it helped some patients with dementia, it didn't help others as much.
Methodology
The study was a cluster-randomised controlled trial comparing structured palliative care nurse visits followed by interprofessional case conferences to usual care.
Potential Biases
Imbalances in baseline characteristics between intervention and control groups may introduce bias.
Limitations
The study faced challenges due to the COVID-19 pandemic, leading to a reduced sample size and potential selection bias.
Participant Demographics
Patients included those with advanced chronic heart failure, chronic obstructive pulmonary disease, and dementia, with a mean age of 75.5 years.
Statistical Information
P-Value
0.009 for pain reduction in dementia patients, 0.68 for symptom burden
Confidence Interval
95% CI: -3.201 to 2.079 for symptom burden, 95% CI: 0.563 to 3.812 for dementia pain reduction
Statistical Significance
p=0.009 for dementia pain reduction, p=0.68 for overall symptom burden
Digital Object Identifier (DOI)
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