Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners

Article


Luckett, Tim, Newton-John, Toby, Phillips, Jane, Holliday, Simon, Giannitrapani, Karleen, Powell-Davies, Gawaine, Lovell, Melanie, Liauw, Winston, Rowett, Debra, Pearson, Sallie-Anne, Raymond, Bronwyn, Heneka, Nicole and Lorenz, Karl. 2020. "Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners." BMJ Open. 10 (2), pp. 1-11. https://doi.org/10.1136/bmjopen-2019-034363
Article Title

Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners

ERA Journal ID200230
Article CategoryArticle
AuthorsLuckett, Tim, Newton-John, Toby, Phillips, Jane, Holliday, Simon, Giannitrapani, Karleen, Powell-Davies, Gawaine, Lovell, Melanie, Liauw, Winston, Rowett, Debra, Pearson, Sallie-Anne, Raymond, Bronwyn, Heneka, Nicole and Lorenz, Karl
Journal TitleBMJ Open
Journal Citation10 (2), pp. 1-11
Article Numbere034363
Number of Pages11
YearFeb 2020
PublisherBMJ
Place of PublicationUnited Kingdom
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2019-034363
Web Address (URL)https://bmjopen.bmj.com/content/10/2/e034363
Abstract

Objective: To explore the perspectives of general practitioners (GPs) concerning the risk of opioid misuse in people with cancer and pain and related clinical considerations.

Design: A qualitative approach using semistructured telephone interviews. Analysis used an integrative approach.

Setting: Primary care.

Participants: Australian GPs with experience of prescribing opioids for people with cancer and pain.

Results: Twenty-two GPs participated, and three themes emerged. Theme 1 (Misuse is not the main problem) contextualised misuse as a relatively minor concern compared with pain control and toxicity, and highlighted underlying systemic factors, including limitations in continuity of care and doctor expertise. Theme 2 ('A different mindset' for cancer pain) captured participants' relative comfort in prescribing opioids for pain in cancer versus non-cancer contexts, and acknowledgement that compassion and greater perceived community acceptance were driving factors, in addition to scientific support for mechanisms and clinical efficacy. Participant attitudes towards prescribing for people with cancer versus non-cancer pain differed most when cancer was in the palliative phase, when they were unconcerned by misuse. Participants were equivocal about the risk-benefit ratio of long-term opioid therapy in the chronic phase of cancer, and were reluctant to prescribe for disease-free survivors. Theme 3 ('The question is always, 'how lazy have you been?') captured participants' acknowledgement that they sometimes prescribed opioids for cancer pain as a default, easier option compared with more holistic pain management.

Conclusions: Findings highlight the role of specific clinical considerations in distinguishing risk of opioid misuse in the cancer versus non-cancer population, rather than diagnosis per se. Further efforts are needed to ensure continuity of care where opioid prescribing is shared. Greater evidence is needed to guide opioid prescribing in disease-free survivors and the chronic phase of cancer, especially in the context of new treatments for metastatic disease.

Keywordscancer pain; pain management; primary care; qualitative research
ANZSRC Field of Research 2020420304. General practice
Byline AffiliationsUniversity of Technology Sydney
University of Newcastle
Stanford University, United States
University of New South Wales
Greenwich Hospital, Australia
University of South Australia
Permalink -

https://research.usq.edu.au/item/y829w/risk-of-opioid-misuse-in-people-with-cancer-and-pain-and-related-clinical-considerations-a-qualitative-study-of-the-perspectives-of-australian-general-practitioners

Download files


Published Version
e034363.full.pdf
License: CC BY-NC 4.0
File access level: Anyone

  • 15
    total views
  • 10
    total downloads
  • 1
    views this month
  • 2
    downloads this month

Export as

Related outputs

Acceptability of a virtual prostate cancer survivorship care model in regional Australia: A qualitative exploratory study
Heneka,, Chambers, Suzanne K., Schaefer, Isabelle and Dunn, Jeff. 2023. "Acceptability of a virtual prostate cancer survivorship care model in regional Australia: A qualitative exploratory study ." Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer. 32 (4), pp. 569-580. https://doi.org/10.1002/pon.6101
Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol of an effectiveness-implementation hybrid (Type 1) randomised trial of a tele-based nurse-led survivorship care intervention (PCEssentials)
Green, Anna, Newton, Robert U, Chambers, Suzanne K, Smith, David P, Tuffaha, Haitham, Galvao, Daniel A, Heathcote, Peter, Patel, Manish I, Christie, David, Egger, Sam, Sara, Sally, Heneka, Nicole and Dunn, Jeff. 2023. "Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol of an effectiveness-implementation hybrid (Type 1) randomised trial of a tele-based nurse-led survivorship care intervention (PCEssentials)." ANZUP Annual Scientific Meeting. Melbourne, Australia 09 - 11 Jul 2023
The importance of developing palliative care quality indicators for the prison setting: why now, and next steps
Schaefer, Isabelle, Heneka, Nicole, DiGiacomo, Michelle, Panozzo, Stacey and Phillips, Jane L.. 2023. "The importance of developing palliative care quality indicators for the prison setting: why now, and next steps." BMC Palliative Care. 22 (1). https://doi.org/10.1186/s12904-023-01150-3
Correction: The importance of developing palliative care quality indicators for the prison setting: why now, and next steps
Schaefer, Isabelle, Heneka, Nicole, DiGiacomo, Michelle, Panozzo, Stacey and Phillips, Jane L.. 2023. "Correction: The importance of developing palliative care quality indicators for the prison setting: why now, and next steps ." BMC Palliative Care. 22 (1). https://doi.org/10.1186/s12904-023-01210-8
A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care
Sara, Sally A. M., Chambers, Suzanne K., Briggs, Russell, Heneka, Nicole and Dunn, Jeff. 2023. "A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care." Seminars in Oncology Nursing. 39 (1). https://doi.org/10.1016/j.soncn.2022.151366
Translating the Prostate Cancer Survivorship Essentials Framework into clinical practice: A participatory research process analysis
Heneka, Nicole, Crowe, Helen, Chambers, Suzanne K., Costello, Anthony, Crowe, Jane, Dundee, Phil, Heerey, Rachel, Stijnen, Elles, Bolger, Chris, Schaefer, Isabelle and Dunn, Jeff. 2023. Translating the Prostate Cancer Survivorship Essentials Framework into clinical practice: A participatory research process analysis.
Designing Organisational Management Frameworks to Empower Episodic Volunteering
Dunn, Jeff, Scuffham, Paul, Hyde, Melissa K., Stein, Kevin, Zajdlewicz, Leah, Savage, Anne, Heneka, Nicole, Ng, Shu-Kay and Chambers, Suzanne K.. 2022. "Designing Organisational Management Frameworks to Empower Episodic Volunteering." Voluntas: International Journal of Voluntary and Nonprofit Organizations. 33 (2), pp. 217-228. https://doi.org/10.1007/s11266-020-00226-5
Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis
Green, Anna, DiGiacomo, Michelle, Luckett, Tim, Abbott, Penelope, Davidson, Patricia Mary, Delaney, Joanne and Delaney, Patricia. 2014. "Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis." International Journal for Equity in Health. 13, pp. 1-16. https://doi.org/10.1186/s12939-014-0126-y
Australian Survey of Current Practice and Guideline Use in Adult Cancer Pain Assessment and Management: Perspectives of Palliative Care Physicians
Lovell, Melanie, Agar, Meera, Luckett, Tim, Davidson, Patricia M., Green, Anna and Clayton, Josephine. 2013. "Australian Survey of Current Practice and Guideline Use in Adult Cancer Pain Assessment and Management: Perspectives of Palliative Care Physicians." Journal of Palliative Medicine. 16 (11), pp. 1403-1409. https://doi.org/10.1089/jpm.2013.0245
Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of oncologists
Luckett, Tim, Davidson, Patricia Mary, Boyle, Frances, Liauw, Winston, Agar, Meera, Green, Anna and Lovell, Melanie. 2014. "Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of oncologists." Asia Pacific Journal of Clinical Oncology. 10 (2), pp. e99-e107. https://doi.org/10.1111/ajco.12040
Assessment and Management of Adult Cancer Pain: A Systematic Review and Synthesis of Recent Qualitative Studies Aimed at Developing Insights for Managing Barriers and Optimizing Facilitators Within a Comprehensive Framework of Patient Care
Luckett, Tim, Davidson, Patricia M., Green, Anna, Boyle, Frances, Stubbs, John and Lovell, Melanie. 2013. "Assessment and Management of Adult Cancer Pain: A Systematic Review and Synthesis of Recent Qualitative Studies Aimed at Developing Insights for Managing Barriers and Optimizing Facilitators Within a Comprehensive Framework of Patient Care." Journal of Pain and Symptom Management. 46 (2), pp. 229-253. https://doi.org/10.1016/j.jpainsymman.2012.07.021
Experience of Advanced Chronic Obstructive Pulmonary Disease: Metasynthesis of Qualitative Research
Disler, Rebecca T., Green, Anna, Luckett, Tim, Newton, Phillip J., Inglis, Sally, Currow, David C. and Davidson, Patricia M.. 2014. "Experience of Advanced Chronic Obstructive Pulmonary Disease: Metasynthesis of Qualitative Research." Journal of Pain and Symptom Management. 48 (6), pp. 1182-1199. https://doi.org/10.1016/j.jpainsymman.2014.03.009
Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach
Virdun, Claudia, Brown, Nicola, Phillips, Jane, Luckett, Tim, Agar, Meera, Green, Anna and Davidson, Patricia M.. 2015. "Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 22 (4), pp. 421-431. https://doi.org/10.1016/j.colegn.2014.07.001
Elements of effective palliative care models: a rapid review
Luckett, Tim, Phillips, Jane, Agar, Meera, Virdun, Claudia, Green, Anna and Davidson, Patricia M.. 2014. "Elements of effective palliative care models: a rapid review." BMC Health Services Research. 14, pp. 1-22. https://doi.org/10.1186/1472-6963-14-136
A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study)
Hosie, Annmarie, Phillips, Jane, Lam, Lawrence, Kochovska, Slavica, Noble, Beverly, Brassil, Meg, Kurrle, Susan, Cumming, Anne, Caplan, Gideon A., Chye, Richard, Ely, Eugene Wesley, Lawlor, Peter G., Bush, Shirley H., Davis, Jan Maree, Lovell, Melanie, Parr, Cynthia, Williams, Sally, Hauser, Katherine, McArdle, Susan, ..., Agar, Meera. 2020. "A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study)." Journal of Palliative Medicine. 23 (10), pp. 1314-1322. https://doi.org/10.1089/jpm.2019.0632
A framework for an asset-informed approach to service mapping
Green, Anna, Luckett, Tim, Abbott, Penelope, DiGiacomo, Michelle, Delaney, John, Delaney, Patricia and Davidson, Patricia Mary. 2017. "A framework for an asset-informed approach to service mapping." Nurse Researcher. 25 (3), pp. 19-25. https://doi.org/10.7748/nr.2017.e1479
Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care
Luckett, Tim, Davidson, Patricia M., Green, Anna, Marie, Natalie, Birch, Mary-Rose, Stubbs, John, Phillips, Jane, Agar, Meera, Boyle, Frances and Lovell, Melanie. 2019. "Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care." Palliative and Supportive Care. 17 (4), pp. 472-478. https://doi.org/10.1017/S1478951518000792
Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families: a qualitative study of provider perspectives
Green, Anna, Abbott, Penelope, Luckett, Tim, Davidson, Patricia Mary, Delaney, John, Delaney, Patricia, Gunasekera, Hasantha and DiGiacomo, Michelle. 2020. "Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families: a qualitative study of provider perspectives." Journal of Interprofessional Care. 34 (3), pp. 388-399. https://doi.org/10.1080/13561820.2019.1692798
Unmet Needs in Chronic Obstructive Pulmonary Disease: A Metasynthesis Protocol
Disler, Rebecca T., Green, Anna, Luckett, Tim, Newton, Phillip J., Inglis, Sally C., Currow, David C. and Davidson, Patricia M.. 2012. "Unmet Needs in Chronic Obstructive Pulmonary Disease: A Metasynthesis Protocol." International Journal of Research in Nursing. 3 (1), pp. 15-20. https://doi.org/10.3844/ijrnsp.2012.15.20
'It’s quite a complex trail for families now'– Provider understanding of access to services for Aboriginal children with a disability
Green, Anna, Abbott, Penelope, Luckett, Tim, Davidson, Patricia Mary, Delaney, John, Delaney, Patricia, Gunasekera, Hasantha and DiGiacomo, Michelle. 2021. "'It’s quite a complex trail for families now'– Provider understanding of access to services for Aboriginal children with a disability." Journal of Child Health Care. 25 (2), pp. 194-211. https://doi.org/10.1177/1367493520919305
Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis
Disalvo, Domenica, Agar, Meera, Caplan, Gideon, Murtagh, Fliss EM, Luckett, Tim, Heneka, Nicole, Hickman, Louise, Kinchin, Irina, Trethewie, Susan, Sheehan, Caitlin, Urban, Kat, Cohen, Joshua, Harlum, Janeane, Long, Brian, Parker, Tricia, Schaefer, Isabelle and Phillips, Jane. 2021. "Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis." Palliative Medicine. 35 (8), pp. 1385-1406. https://doi.org/10.1177/02692163211024451
Quality of online self-management resources for adults living with primary brain cancer, and their carers: a systematic environmental scan
Schaefer, Isabelle, Heneka, Nicole, Luckett, Tim, Agar, Meera R., Chambers, Suzanne K., Currow, David C., Halkett, Georgia, Disalvo, Domenica, Amgarth-Duff, Ingrid, Anderiesz, Cleola and Phillips, Jane L.. 2021. "Quality of online self-management resources for adults living with primary brain cancer, and their carers: a systematic environmental scan." BMC Palliative Care. 20 (1), pp. 1-11. https://doi.org/10.1186/s12904-021-00715-4
The Health Professionals Guide to Delivering Psychological Care for Men with Prostate Cancer
Chambers, Suzanne K, Heneka, Nicole and Dunn, Jeff. 2021. The Health Professionals Guide to Delivering Psychological Care for Men with Prostate Cancer. Australia. Australian Academic Press.
Mitigating opioid errors in inpatient palliative care: A qualitative study
Heneka, Nicole, Bhattarai, Priyanka, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2020. "Mitigating opioid errors in inpatient palliative care: A qualitative study." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 27 (3), pp. 304-312. https://doi.org/10.1016/j.colegn.2019.09.005
A psychosocial care model for men with prostate cancer
Chambers, Suzanne K., Galvao, Daniel A., Green, Anna, Lazenby, Mark, Newton, Robert U., Oliffe, John L., Phillips, Jane L., Phillips, Rachel, Ralph, Nicholas, Sara, Sally, Heathcote, Peter and Dunn, Jeff. 2019. A psychosocial care model for men with prostate cancer. Sydney, Australia. Prostate Cancer Foundation of Australia.
Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review
Phillips, Jane L, Heneka, Nicole, Bhattarai, Priyanka, Fraser, Claire and Shaw, Tim. 2019. "Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review." Medical Education. 53 (9), pp. 886-902. https://doi.org/10.1111/medu.13895
Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study
Heneka, Nicole, Bhattarai, Priyanka, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2019. "Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study." Palliative Medicine. 33 (4), pp. 430-444. https://doi.org/10.1177/0269216319832799
A phase III wait-listed randomised controlled trial of novel targeted interprofessional clinical education intervention to improve cancer patients’ reported pain outcomes (The Cancer Pain Assessment (CPAS) Trial): study protocol
Phillips, Jane L., Heneka, Nicole, Lovell, Melanie, Lam, Lawrence, Davidson, Patricia, Boyle, Frances, McCaffrey, Nikki, Fielding, Sally and Shaw, Tim. 2019. "A phase III wait-listed randomised controlled trial of novel targeted interprofessional clinical education intervention to improve cancer patients’ reported pain outcomes (The Cancer Pain Assessment (CPAS) Trial): study protocol." Trials. 20. https://doi.org/10.1186/s13063-018-3152-z
Self-Perceived Pain Assessment Knowledge and Confidence (Self-PAC) Scale for Cancer and Palliative Care Nurses: A Preliminary Validation Study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise and Lam, Lawrence. 2018. "Self-Perceived Pain Assessment Knowledge and Confidence (Self-PAC) Scale for Cancer and Palliative Care Nurses: A Preliminary Validation Study." Pain Management Nursing. 19 (6), pp. 619-626. https://doi.org/10.1016/j.pmn.2018.07.008
Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report
Heneka, N., Shaw, T., Azzi, C. and Phillips, J. L.. 2018. "Clinicians’ perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report." Supportive Care in Cancer. 26 (10), pp. 3315-3318. https://doi.org/10.1007/s00520-018-4231-0
Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis
Heneka, Nicole, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2018. "Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis." Journal of Palliative Medicine. 21 (6), pp. 825-835. https://doi.org/10.1089/jpm.2017.0578
Opioid errors in inpatient palliative care services: a retrospective review
Heneka, Nicole, Shaw, Tim, Rowett, Debra, Lapkin, Samuel and Phillips, Jane L.. 2018. "Opioid errors in inpatient palliative care services: a retrospective review." BMJ Supportive and Palliative Care. 8 (2), pp. 175-179. https://doi.org/10.1136/bmjspcare-2017-001417
Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service
Phillips, Jane L., Lobb, Elizabeth, Mohacsi, Paula, Heneka, Nicole and Currow, David. 2018. "Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 25 (1), pp. 39-43. https://doi.org/10.1016/j.colegn.2017.03.004
Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2017. "Can A Complex Online Intervention Improve Cancer Nurses’ Pain Screening and Assessment Practices? Results from a Multicenter, Pre-post Test Pilot Study." Pain Management Nursing. 18 (2), pp. 75-89. https://doi.org/10.1016/j.pmn.2017.01.003
Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review
Heneka, Nicole, Shaw, Tim, Rowett, Debra and Phillips, Jane L.. 2016. "Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review." Palliative Medicine. 30 (6), pp. 520-532. https://doi.org/10.1177/0269216315615002
Identifying Opioid Medication Error Types, Incidence and Patient Impact in Adult Oncology and Palliative Care Settings: A Systematic Review
Heneka, Nicole, Phillips, Jane L., Rowett, D. and Shaw, Tim. 2015. "Identifying Opioid Medication Error Types, Incidence and Patient Impact in Adult Oncology and Palliative Care Settings: A Systematic Review." 42nd COSA Annual Scientific Meeting. Hobart, Australia 17 - 19 Nov 2015 United Kingdom.
Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective
Phillips, Jane L., Lovell, Melanie, Luckett, Tim, Agar, Meera, Green, Anna and Davidson, Patricia. 2015. "Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective." Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 22 (1), pp. 33-41. https://doi.org/10.1016/j.colegn.2013.11.002
Multi-Centre Pre-Post Test Trial of a Complex QStream (c) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices
Phillips, Jane, Heneka, Nicole, Lam, Lawrence and Shaw, Tim. 2014. "Multi-Centre Pre-Post Test Trial of a Complex QStream (c) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices." Asia Pacific Journal of Clinical Oncology. 10, pp. 206-206.
A Complex QStream (R) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices: Results from a Quasi-Experimental Study
Phillips, Jane, Heneka, Nicole, Lam, Lawrence and Shaw, Tim. 2014. "A Complex QStream (R) Pain Assessment Intervention on Cancer Nurses' Pain Screening and Assessment Practices: Results from a Quasi-Experimental Study." Asia Pacific Journal of Clinical Oncology. 10, pp. 136-136.
Impact of a novel online learning module on specialist palliative care nurses’ pain assessment competencies and patients’ reports of pain: Results from a quasiexperimental pilot study
Phillips, Jane L., Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2014. "Impact of a novel online learning module on specialist palliative care nurses’ pain assessment competencies and patients’ reports of pain: Results from a quasiexperimental pilot study." Palliative Medicine. 28 (6), pp. 521-529. https://doi.org/10.1177/0269216314527780
Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders
Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Exploring opiate errors in the specialist cancer and palliative care setting: perceptions of key stakeholders." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit
Phillips, Jane, Heneka, Nicole and Shaw, Tim. 2013. "Mapping cancer pain screening, assessment and reassessment practices within one Australian health district: results from a baseline chart audit." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.
Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study
Phillips, Jane, Heneka, Nicole, Hickman, Louise, Lam, Lawrence and Shaw, Tim. 2013. "Impact of a Qstream Online Learning Module on Palliative Care Nurses’ Pain Assessment Competencies and Patients’ Reports of Pain: Results from a Quasi-Experimental Pilot Study." COSA Annual Scientific Meeting 2013. Adelaide, Australia 12 - 14 Nov 2013 Australia.