MU researcher studies relationship between hospice communication, patient pain

Friday, October 1, 2010 | 6:15 p.m. CDT; updated 9:12 a.m. CDT, Monday, October 4, 2010

Debra Parker Oliver is an associate professor of family and community medicine at MU. An earlier version of this article incorrectly stated her department affiliation.

COLUMBIA — The decision to care for dying loved ones during their final days often leads to other difficult choices for caregivers. An MU researcher hopes to make one of those decisions — how best to alleviate the loved one’s pain — easier.

*Debra Parker Oliver, associate professor of family and community medicine, has recently secured a $2.1 million grant from the National Institutes of Health to look at how improved communication between caregivers and hospice staff affects both caregiver and patient.

“The problem that most severely impacts people in hospice care is pain management,” said Parker Oliver, who is leading a team of researchers at MU and other universities.

Family members caring for loved ones often have misconceptions about pain-relieving drugs, such as morphine, and are hesitant to administer them, Parker Oliver said. They are guided by the impression, bolstered by messages in mass media, that such drugs are always bad, she said.

But for dying patients, addiction isn't the issue. Because the average lifespan for patients who enter hospice care is only 60 days, the benefits of the drugs often outweigh the risks, Parker Oliver said.

Missouri has 132 hospice providers, according to Missouri Hospice & Palliative Care Association. Many of these providers are small, yet they provide care to large, rural areas, making it difficult for caregivers to travel to meet with hospice staff and nearly impossible for hospice staff to visit all patients, Parker Oliver said. Connecting caregivers and hospice staff with technology could lead to better care.

A pilot study conducted by Parker Oliver from 2006 to 2008 showed that when caregivers participated in patient-care meetings with hospice staff using video-conferencing technology, their fears were eased, and they had a better understanding of — and willingness to administer — pain-relieving drugs.

Parker Oliver's new study, which involves three Missouri hospice programs, stems from that research. She declined to name the programs because, on Friday, she doesn't have their permission to do so.

She and her research team plan to monitor 544 patients, their caregivers and hospice-care professionals. They will monitor video conferences every other week between caregivers and the professionals, measuring the caregiver’s perception of pain after each session by asking a series of questions. The researchers will also measure patients’ levels of pain on a 0-10 scale. The study, which began Sept. 15, will last four years.

The researchers hope their findings will definitively prove that caregivers’ involvement with the hospice staff positively affects patient pain. They also seek to determine the cost-effectiveness and feasibility of the program.

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