Characterizing Pain Experiences: African American Patients With Multiple Myeloma Taking Around-the-Clock Opioids.
Sarah M Belcher, Deborah Watkins Bruner, Craig C Hofmeister and 3 others
PMID 32945786WHAT IT FOUND
Everyday pain was universal among African American patients with multiple myeloma taking around-the-clock opioids, and it interfered with sleep, work, walking, and daily activity.
Common barriers included disliking pills, addiction worries, constipation, and drowsiness; half also met a depression threshold.
Key findings
01All 34 participants reported everyday pain; mean severity was 4.6 and worst pain was 6.3, while all were on around-the-clock opioids.
02Highest barrier scores were disliking pills (4.0), worry about addiction (3.5), upset from constipation (3.2), and bother from drowsiness (3.0); over 60% were concerned about decreased medication effectiveness and were distressed by medication-related nausea.
03Half of participants (17) met or exceeded the depression cutoff of 10; one had severe major depression; mean PHQ-8 was 9.6 and scores ranged from 1 to 22.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 34 patients were analysed, so the results describe this small group and should not be treated as a stable estimate for all African American patients with multiple myeloma. This was a secondary analysis of baseline data from an observational study, not a trial, so it cannot show that any treatment caused pain relief or that addressing barriers would improve outcomes. All participants were already prescribed around-the-clock opioids, so findings may not apply to patients using other pain medicines or no opioids. Participants were recruited from clinics in the Southeast United States, so results may not generalize to other regions or health systems. Data were collected between 2013 and 2015, before the height of the U.S. opioid epidemic, so attitudes toward opioids may have changed since then.
Declared interests
No conflicts-of-interest or funding statement is included in the supplied article text. The publication types list NIH extramural research support.
The easy way to misread this
Do not read these barrier and depression rates as evidence that a nurse-led pain or depression intervention works. This was a small descriptive analysis of baseline data from 34 patients already taking around-the-clock opioids, with no comparison group or follow-up.