Palliative Complex Pain Board: Interdisciplinary Discussion of Interventional Procedural Options

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of Pain and Symptom Management

Abstract

Approximately two-thirds of patients with advanced cancer experience pain (1). Referrals for interventional procedures remain limited despite their clear benefits. Timeliness of interventional procedures is complicated by a lack of provider education regarding procedural options and collaboration with proceduralists (2). The limited prognosis of these patients necessitates more urgent assessment and treatment. There is a lack of literature regarding access to this type of care. Objectives Modeled after a tumor board, we created a complex-pain board of experts to discuss and coordinate care for palliative care patients (3). The goal of this board was to improve access to and timeliness of interventional procedures, and to improve patient outcomes.

Methods: The complex-pain board discusses selected patients being followed by palliative teams in the inpatient setting, at home, and in oncology clinic. The panel has been ongoing since 2022 with participants including palliative providers, interventional radiologists, anesthesia pain providers, a PM&R physician, a neurosurgeon, and a pain psychologist. We have monthly meetings where the board discusses each patient, determines potential interventional options, and arranges follow-up.

Results: Over the past two years, over seventy patients have benefited from the expertise and collaborative care of this complex-pain board. Before review, these patients typically had poorly controlled pain, high opioid requirements, opioid intolerance, or high risk for emergency department (ED) visits or hospital readmissions for pain. Challenges included coordinating with providers from multiple groups, attendance of providers involved, and coordination of follow-up.

Conclusion: A complex-pain board discussing patients with intractable pain can improve access to and timeliness of interventional procedures, optimize quality of life, and decrease preventable ED visits and hospital admissions for uncontrolled pain. Next steps include designated staff to coordinate referrals and implementation of a smart phrase in the EMR to automate data collection to further study the benefits of this board.

Volume

69

Issue

5

First Page

e568

Last Page

e569

Comments

Annual Assembly of Hospice and Palliative Care, Feb. 5-8, 2025, Denver, CO

DOI

10.1016/j.jpainsymman.2025.02.227

ISSN

0885-3924

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