6 minute Speed talk Palliative Care Nurses Australia Conference 2020

Clinical Evidence in Palliative Care - Pain Management Update (70351)

Caroline Phelan 1 , Katrina Erny-Albrecht 1 , Jennifer Tieman 1
  1. CareSearch, Flinders University, Adelaide, South Australia

Introduction: CareSearch is part of the National Palliative Care Project funded by the Australian Government and is the only Australian-based service providing access to evidence-based information and resources in palliative care. A recent update to the 17 Clinical Evidence-Patient Management topics revealed why ensuring currency of the evidence is an important part of providing useful support for best practice. For example, new practice guidelines and recommendations were revealed for pain management.

Aims: The presentation will discuss the update to the pain Management pages and demonstrate why the currency of evidence is important for practice in palliative care.

Approach: In line with the CareSearch quality processes topic updates were based on searching multiple literature databases for new systematic reviews (SRs), guidelines and where needed randomised controlled trials. Articles selected for full text analysis were appraised including use of the SIGN methodology for SRs and AGREE II for guidelines. Following review and synthesis of the evidence by an experienced researcher with clinical experience as Clinical Nurse Consultant in Pain Management, all content was reviewed by external expert reviewers.

Outcomes: As expected, in some cases, the newer evidence supported current content whilst others highlighted the need for change or acknowledged that the evidence was contested. With respect to pain, there was evidence that practice is changing, for example, recommendations about managing breakthrough pain are evolving and there is a new consensus on management of breakthrough opioids. There was also evidence of need for improvement such as implementation of pain assessment for patients with non-cancer conditions. New areas of evidence and knowledge were also identified including the emergence of new treatments in pain management such as cannabinoids and the related legislative changes.

Conclusion: We highlight changes in the evidence supporting pain management in palliative care to reveal a dynamic and changing knowledge and practice base. Increasingly health professionals require access to evidence to support best practice in an environment of increasing community demand and media attention that is often based on opinion. The contribution of evidence to best practice can only be supported through maintaining currency and access to resources like CareSearch.