Key Clinical Summary

• A 1-hour National Comprehensive Cancer Network (NCCN) guideline-based educational session significantly improved hospitalists’ confidence in managing cancer-related pain and increased guideline familiarity from 18.7% to 100%.
• Evidence-based prescribing practices improved, including increased use of multimodal analgesia, adjunct therapies, and a prescription drug monitoring program (PDMP).
• The scalable intervention addressed major training gaps, with 93.8% of hospitalists lacking prior formal pain or palliative care education.

A targeted, guideline-based educational intervention significantly improved cancer pain management among hospitalists in a Florida community hospital, according to findings presented at the 2026 National Comprehensive Cancer Network (NCCN) Annual Conference. The initiative addressed critical training gaps in oncology-related pain care, particularly in resource-limited settings where access to palliative care specialists is limited.

Study Findings

Hospitalists frequently manage cancer-related pain in community hospitals, yet most lack formal training. In this study, 93.8% of participants reported no prior education in pain or palliative care, and only 6.3% had received instruction specific to cancer pain management.

The intervention consisted of a 1-hour educational session focused on NCCN Cancer Pain Guidelines, emphasizing multimodal analgesia and evidence-based prescribing. Delivered both in person and electronically, the session targeted hospitalists in a Florida community hospital, where approximately half managed 3 to 5 cancer pain cases weekly.

Post-intervention results demonstrated marked improvements across multiple metrics. The proportion of hospitalists reporting being “very confident” in managing cancer pain increased from 0% to 21.4%. Familiarity with NCCN guidelines rose from 18.7% to 100%, eliminating self-reported unfamiliarity entirely.

Practice changes were also significant. Routine PDMP checks increased from 62.5% to 85.7%, while use of adjunct analgesics rose from 87.5% to 100%. Specific adjuvant therapies saw notable gains, including duloxetine use (42.9% to 71.4%), amitriptyline (7.1% to 28.6%), and methadone (6.3% to 14.3%).

Barriers to care shifted as well. Reports of lack of training decreased from 56.3% to 28.6%, while awareness of pain complexity increased from 68.8% to 92.9%. Interest in ongoing education remained high at over 85%.

Clinical Implications

These findings highlight a persistent gap in oncology pain management training among hospitalists, particularly in community settings where oncology specialists and palliative care resources may be limited. A brief, low-resource educational intervention demonstrated measurable improvements in both clinician confidence and adherence to evidence-based practices.

For oncology leaders and pathway developers, the results suggest that integrating NCCN guideline education into hospitalist workflows could standardize cancer pain management across care settings. Improved use of multimodal analgesia and adjunct therapies aligns with best practices and may enhance patient outcomes while reducing reliance on opioids alone.

From a payer and health system perspective, the intervention offers a scalable, cost-effective quality improvement model. Increased PDMP utilization and guideline adherence may support safer prescribing practices and align with value-based care initiatives.

Importantly, improved clinician education may translate into more equitable access to evidence-based cancer pain management for patients treated outside academic centers, addressing disparities in supportive oncology care.

Conclusion

A brief, NCCN-based educational intervention substantially improved cancer pain management practices among hospitalists in a community hospital. The scalable model offers a practical pathway to enhance evidence-based oncology care and address training gaps in resource-limited settings.

Reference

Aziz S, Afridi S, Samejo MA, Ombada M, Buradkar A, Shah Z. Improving cancer pain management among hospitalists in a community setting through a targeted educational intervention. Presented at: 2026 NCCN Annual Conference; March 27-March 29, 2026; Orlando, Florida, and virtual.