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. Author manuscript; available in PMC: 2013 Aug 1.
Published in final edited form as: Pain Med. 2012 Jul 3;13(8):1004–1017. doi: 10.1111/j.1526-4637.2012.01405.x

Table 3.

Adoption of Evidence-Based Pain Practices as Measured by the Cancer Pain Practice Index (CPPI) scores Pre and Post-Intervention

Experimental Group Control Group E vs. C p-value1
Baseline Post Baseline Post
n %* n %* Chg n %* n %* Chg
Overall CPPI: mean 202 32.5 166 34.1 +1.6 197 30.8 171 34.1 +3.3 2
COMPREHENSIVE ADMISSION ASSESSMENT
Individual CPPI Indicators
1. Valid pain scale use at admission 202 67.3 168 86.9 +19.6 197 72.1 171 83.0 +10.9 0.16
2. Comprehensive assessment- primary (Pain Intensity, Pain Location, Pain Quality, Pain Duration/Pattern, Impact of Pain on Function) 175 67.0 159 67.9 +0.9 178 67.0 157 76.3 +9.3 0.21
3. Comprehensive assessment- other (Detailed Pain history including description of previous & current pain episodes & treatment effectiveness; Physical exam- including musculoskeletal & neurological assessment; Presence or absence of delirium; Things that make pain better; Things that make pain worse; and Presence of Anxiety and Depression 175 13.1 159 11.5 −1.6 178 16.5 157 16.7 +0.2 0.67
4. Reports of moderate/severe (≥ 5) pain followed by pain severity reassessment within 24 hours 47 12.2 44 16.7 +4.5 48 8.2 45 15.2 +7 0.62
5. Increases in pain medications for consecutive reports of pain severity 5 or greater within 24 hrs 19 32.9 19 49.1 +16.2 19 17.5 22 33.3 +15.8 0.81
6a. Patients with admission report of pain as mild (1–4) with order for nonopioid or combination of opioid- nonopioid analgesic within 24 hours of admission (Items 6a & 6b combined on CPPI) 30 73.3 31 90.3 +17 32 81.3 53 88.7 +7.4 0.51
6b. Pts. with admission report of pain as moderate (5–6) or < with order for opioid analgesic within 24 hours of admission (Items 6a & 6b combined on CPPI) 33 90.9 30 96.7 +5.8 26 92.3 23 95.7 +3.4 0.79
7. Pts. with opioid order with bowel regimen initiated (includes both laxative & stool softener) 172 33.7 160 35.0 +1.3 175 30 150 32.0 +2 0.94
8. Pts. with opioids ordered who were monitored each day; a focused assessment is completed for the five most common analgesic-induced side effects (1. Respiratory depression, 2. Sedation, 3. Nausea and vomiting, 4. Constipation, 5. Delirium) 172 19.2 160 19.2 0 175 19.4 150 17.3 −2.1 0.71
9. Non-pharmacologic therapies used 182 39 162 50.6 +11.6 182 11 159 37.1 +26.1 0.00
10. Focused assessments that include a review of the Pain Management Plan (PMP) 179 59.9 157 49.1 −10.8 177 61.2 157 53.3 −7.9 0.69
11. Pts. with documentation of a written pain management plan 127 26.2 143 20.8 −5.4 166 39.3 149 28.4 −10.9 0.57
*

An individual CPPI score is presented as a % of applicable EBPs a patient received. The higher the % the more EBPs received.

1

The p-values were obtained from logistic regression model using contrast Experimental Post Intervention (EPI) – Experimental Baseline (EB) –Control Post Intervention (CPI) – Control Baseline (CB), where each indicator (0 or 1) was treated as the response variable and intervention (4 categories: EPI, EB, CPI, and CB) was the only independent variable.

2

p-value calculated from GEE final model is reported in Table 4