A pathway linking patient participation in cancer consultations to pain control

Objective To test a pathway through which a tailored, pain management education–coaching intervention could contribute to better cancer pain control through the effects of patients' communication about pain on physician prescribing of pain medication. Methods Secondary analysis of data from a randomized controlled trial that tested the effects of a tailored education–coaching intervention on pain control for patients with advanced cancer. The current analysis focused on a subset of the patients (n = 135) who agreed to have their consultations audio‐recorded. Patients' active communication about pain (e.g., expressing questions, concerns, and preferences about pain‐related issues) was coded from audio‐recordings. Change in pain medication was measured by patient self‐report. Improvement in pain control was scored as the difference between baseline pain score and pain reported at 6 weeks. Results Patients' pain‐related communication was a significant predictor of patient‐reported changes in physician prescribing of pain medication (p