Seventeen RCTs were included in the review of interventions to overcome barriers to pain management. The total number of patients was not stated. Most trials used small sample sizes with no assessment of study power. Most trials on professional education and pain assessment did not report the effect of the intervention on patients' pain.
Interventions to reduce patient-related barriers, patient education (11 RCTs): Five of 11 RCTs found a statistically significant decrease in pain with respect to baseline between the interventions and control group, but in only two of these could the effect be classed as clinically significant. Eight of 10 trials reported a statistically significant improvement in knowledge about cancer pain and its management in the intervention group as compared to the control group. Three of six trials reported a statistically significant improvement on patients' adherence to analgesics in the intervention group compared to the control group.
Interventions to reduce professional-related barriers (six RCTs): Two RCTs provided professional education to nursing staff. One did not present relevant outcomes; the other found statistically significant increases in nurses' knowledge, but not on other outcomes. Two RCTs evaluated the effect of pain assessment. One did not result in improved pain control and the other was not reported in full. In two RCTs on pain consultation, patients' pain decreased statistically significantly, but the adequacy of pain treatment did not change.