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