Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display

3507 - Knowledge of pain management in patients with painful bone metastases; A multicentre randomized trial on pain education


09 Oct 2016


Poster display


Jenske Geerling


Annals of Oncology (2016) 27 (6): 455-461. 10.1093/annonc/mdw384


J.I. Geerling1, A. Reyners2, Y. van der Linden3, V. Mul4, P. Westhoff5, A. de Graeff6, C. Rodenhuis7, E. de Nijs8, T. Muilenburg7

Author affiliations

  • 1 Centre Of Expertise Palliative Care, University Hospital Groningen (UMCG), 9713 GZ - Groningen/NL
  • 2 Medical Oncology, University Hospital Groningen (UMCG), Groningen/NL
  • 3 Radiation Oncology, Leiden University Medical Center (LUMC), Leiden/NL
  • 4 Radiation Oncology, University Hospital Groningen (UMCG), Groningen/NL
  • 5 Radiation Oncology, Radboud University Medical Centre Nijmegen, Nijmegen/NL
  • 6 Medical Oncology, University Medical Center Utrecht, Utrecht/NL
  • 7 Radiation Oncology, University Medical Center Utrecht, Utrecht/NL
  • 8 Centre Of Expertise Palliative Care, Leiden University Medical Center (LUMC), Leiden/NL


Abstract 3507


Education of patients regarding pain management may improve patient empowerment and, consequently, reduce pain intensity. To investigate the effect of education on pain intensity, a multicentre phase 3 study was conducted between 1-3-2011 and 1-4-2016. A total of 354 patients who received radiotherapy for painful bone metastases were randomized between nurse-led tailored education regarding pain management or care as usual. A worst pain score of ≥5 on a 0-10 numeric rating scale (NRS) was one of the inclusion criteria. The primary endpoint was pain intensity. Here we report on pain knowledge in patients randomized in the education arm.


Patient characteristics, pain intensity (NRS) and patients' thoughts regarding pain management were assessed using a structured interview. This interview took place between randomization and start of radiotherapy. Patients were asked whether they completely agreed-completely disagreed on a 5 point Likert scale with the following statements 1) cancer pain can be relieved effectively 2) pain medication should be given only when pain is severe 3) most cancer patients will become addicted to pain medication 4) it is better to give the lowest amount of pain medication, so that larger doses can be used later if pain increases 5) it is better to give pain medication around the clock than only when needed 6) non-pharmacological interventions can relieve pain 7) patients are often overmedicated 8) use of pain medication can be changed without consulting a physician. Lack of knowledge was identified if they completely or fairly disagreed on statement 1, 5, 6 or, completely or fairly agreed on statement 2-4, 7 or 8.


167 patients were interviewed, mean age 65 ±10 years. Mean worst pain at inclusion was 7.9 ±1.4. 52% of patients used strong opioids (WHO step 3). Most patients (91%) lacked knowledge of at least one statement (median 2, range 1-6). Lacks were found most frequently for statements 4 (69%), 2 (41%), 3 and 7 (both 28%). Patients' knowledge was best about statements 8 (77% disagreed), 5 (74% agreed) and 1 (73% agreed).


Most patients lack sufficient knowledge on different topics of pain management, advocating tailored pain education.

Clinical trial identification

ZonMW 11510007 07-10-2010

Legal entity responsible for the study





All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings