Improving Cancer Pain and Symptom Management Through Knowledge Translation


OAPN research projects are made possible through the support and generosity of The Lewis and Ruth Sherman Foundation.


Problem Statement: Despite available research evidence, many patients with cancer experience pain and other symptoms that are not well managed by health providers. Inadequate health provider knowledge and skills and inconsistent care due to poor implementation and uptake of evidence-informed practices contribute to poor pain and symptom management. Evidence on the effectiveness of knowledge translation (KT) interventions targeting health providers to improve pain and symptom management is incomplete. Studies have focused on education and little is known about interventions to promote the implementability and uptake of evidence-based tools by health providers. The Ontario Cancer Symptom Management Collaborative (OCSMC) involves KT strategies to promote the uptake of evidence-based practices in14 regional cancer centres (RCCs) and 23 community satellite clinics. KT strategies include the use of standardized assessment tools for screening and symptom management guidelines (SMGs) that are available online in several formats (algorithms, pocket guides, iPhone apps). In the OCSMC, RCC leads are responsible for developing, implementing, and reporting on locally relevant KT plans. Screening has been the focus of quality improvement efforts and pain and symptom research in Ontario and other provinces. A major gap is our understanding of the impact of KT interventions on symptom management. The extent to which screened and symptomatic patients receive appropriate care through the use of SMGs is not known. This research addresses CCSRI goals to close the research to practice gap by providing the first evaluation of the OCSMC KT strategies to improve pain and symptom management care.


Research Objectives: The overall goal of this study is to promote the uptake of evidence-informed pain and symptom management practices among health providers in ambulatory cancer care settings through improved understanding of KT. The Knowledge to Action framework guides this research. Specific study objectives are to:

1. Compare the context and characteristics of regional KT plans, interventions and outcomes for promoting SMG/algorithm use in Ontario RCCs.

2. Examine health provider perceptions of regional KT interventions, SMG/algorithm implementability, and how SMGs are integrated in their practice.

3. Determine the strengths/limitations of regional KT interventions and impact on SMG use and outcomes.

4. Generate recommendations about effective KT for improving PSM that are relevant to cancer centres in Ontario and other jurisdictions.


Study Design and Methods: A descriptive study employing qualitative and quantitative methods will be conducted using an integrated KT approach. Participants include healthcare decision-makers and providers (i.e. physicians, nurses, allied providers) from 14 RCC and 23 community hospitals. Methods will include document analysis of regional KT plans, a survey of health providers, and key informant interviews with decision-makers and health providers. The data from multiple sources will be compared and synthesized to generate recommendations for future KT initiatives. A national stakeholder meeting will be held using a deliberative dialogue approach to engage researchers, knowledge users and other stakeholders in generating nationally relevant practice, policy, and research recommendations.


Significance: Dialogue recommendations from national stakeholders will promote the scaling up study findings about effective KT interventions for pain and symptom management to knowledge users in Ontario and other jurisdictions. Promoting increased health provider use of best practices for pain and symptom management may improve the quality of care and quality of life for cancer survivors.


e-Newsletter 1

e-Newsletter 2

e-Newsletter 3

A Citizen Panel was recently held on September 19th, 2015, to examine study results and generate recommendations for effective knowledge translation strategies. Please visit the McMaster Health Forum website for the report on this stakeholder meeting: