Guinigundo, A.S., Maxwell, C.L., Vanni, L., Morrow, P.K., Reiner, M., Shih, A., . . . Blanchard, E. (2018). A randomized, single-blind study evaluating the effect of a bone pain education video on reported bone pain in patients with breast cancer receiving chemotherapy and pegfilgrastim. Pain Management Nursing, 19, 693–706.
To investigate the effect of bone pain education on pegfilgrastim-related bone pain in patients with breast cancer receiving chemotherapy and pegfilgrastim. Patients were either shown a general video or specific bone pain video and then bone pain was assessed using patient surveys that asked about bone pain severity and location, medications usage, and information from adverse reporting.
Patients were randomized 1:1 to view either a generalized education video on chemotherapy side effects or a video on bone pain following chemotherapy and pegfilgrastim.
Randomized single-blind study
Patient-reported maximum bone pain was similar in both groups. General versus specific C1 3.2 versus 3.5 (p = 0.3479); across all cycles, 4.1 versus 4.6 (p = 0.2196). Other measures of bone pain were also similar between groups.
Bone pain was highest in C1 and then decreased and remained stable in subsequent cycles. Bone pain medication usage was also similar between the two groups with the highest usage in C1.
The only area that showed significance was in the 65-75 age group. Maximum bone pain for general video was 2.9 versus 4.6 (p = 0.0599); mean bone pain was 1.3 versus 2.6 (p = 0.0220) and AUC was 5.3 versus 10.9 (p = 0.018).
The bone pain-specific education did not improve patient’s perception of bone pain reported in this patient population. However, this study did provide information on the prevalence, timing, severity, and location of pegfilgrastim-related bone pain. This may help focus future research on treatments for bone pain.
The major nursing implication is that pain is highest in C1. It is important to educate patients so they do not stop pegfilgrastim treatments due to pain. They need to know the amount of pain decreased is subsequent cycles. Education must always be individualized to be effective. Videos do not replace one-on-one teaching, but new educational methods need to be developed. More research is needed in different patient populations and on specific treatment experiences.