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Structured and Patient-empowered Cancer Pain Control Program

 Ospital ng Maynila Medical Center

 

Departments of Surgery, Internal Medicine, Pediatrics, Gynecology, and ENT

 

Situation:

 

No document on cancer pain control program in OMMC, in every clinical department

No monitoring system whether cancer pain is adequately or inadequately controlled

No pain scoring system utilized

Residents – no or few have yellow pads for opioid prescription

Pharmacy – poor utilization of available opioids

 

Targets:

 

A cancer pain control program in OMMC, in every clinical department – in the form of a document and structured.

Presence of monitoring system whether cancer pain is adequately or inadequately controlled.

There is a standardized pain scoring system.

At least majority, if not all of the residents have a yellow pad.

Pharmacy has adequate supply of opioids, particularly, morphine and other analgesics and these drugs are adequately utilized.

 

 

Pain control monitoring record

 

Main modality of pain control: pharmacologic therapy

            2-step: modified WHO analgesic ladder, RTC, oral

Surgery, Radiotherapy, and Chemotherapy

Psychotherapy

 

End-points:

Adequate pain control:

            Controlled (0-3) in less than 2 days after admission

            Controlled (0-3) at least 2 days prior to discharge

 

Patient/relative empowered

            As seen in the ward

            As seen in outpatient follow-up (1 month)

 

MD develops habit of pain control

            As seen in the ward

            As seen in outpatient follow-up (1 month)

 

Regular reporting – Hospital Tumor Board; Department’s Monthly Service Performance Report