461: Integrating Nursing and Primary Care in Multidisciplinary Cancer Pain Management of Siloam Hospital

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic cancer related pain, Developing methodology/technology, Assessment and Measurement of Pain/Nociception, Treatment/management

Background and Aims: Cancer pain remains inadequately controlled despite established guidelines and expanding pharmacologic and interventional options. Fragmented care pathways, unclear role delineation, and weak coordination across settings contribute to persistent undertreatment. Nurses and general practitioners (GPs) are strategically positioned to influence continuity, monitoring, and patient-centered analgesic decision-making, yet their integration within multidisciplinary tumor boards and structured care models remains inconsistent. This review aims to synthesize current evidence regarding the roles of nursing and primary care in multidisciplinary cancer pain management, with particular attention to tumor board configurations, communication infrastructure, and implementation barriers that influence analgesic outcomes and quality of care.

Methods: A structured narrative review was conducted based on 178 screened publications addressing cancer pain management, multidisciplinary team models, nursing roles, and primary care integration. Qualitative, quantitative, mixed-methods, and organizational studies were included to capture conceptual, clinical, and systems-level perspectives. Data were analyzed thematically, focusing on role delineation, care transitions, communication processes, and outcome measurement. Particular attention was given to tumor board configurations and integrated care pathways. The synthesis evaluated reported pain outcomes, team processes, and structural determinants influencing implementation. Gaps in longitudinal and comparative designs were also examined to identify research priorities for optimizing multidisciplinary cancer pain care.

Results: The literature demonstrates consistent recognition of nurses as central to assessment, education, monitoring, and advocacy in cancer pain management, although authority limitations and staffing constraints reduce impact. GPs provide continuity during care transitions, yet integration into multidisciplinary decision-making remains variable. Multidisciplinary models, including palliative-focused tumor boards and integrated pathways, can modify treatment plans and improve reported pain metrics. However, mechanisms underlying benefit are poorly specified, and long-term sustainability remains uncertain. Communication failures, unclear ownership of analgesic plans, regulatory barriers, and insufficient interprofessional education repeatedly emerge as structural impediments limiting effective implementation across inpatient and community settings.

Conclusions: Nursing and primary care integration is essential for closing the persistent gap in cancer pain relief. Multidisciplinary models show promise, but effectiveness depends less on the mere presence of multiple disciplines and more on clearly defined roles, reliable communication systems, and structured follow-up responsibility. Implementation science approaches, longitudinal evaluation, and comparative team-model research are urgently needed. Future frameworks should extend beyond pain intensity to include function, quality of life, and patient-reported experience. Sustainable cancer pain improvement requires organizational choreography that aligns expertise, continuity, and accountability across oncology, palliative, pain, and primary care settings.

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Presenting Author: Henry Riyanto Sofyan
Submitting Author: HENRY RIYANTO

Senior Author: Made Agus Mahendra Inggas

IASP 2026 Global Year theme of Neuropathic Pain: No

• Anne Dina Soebroto: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Eunike Novrilia: Registered Nurse Pain - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Ratu Novia Putri Aulia: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Daniel Budi Utomo: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Liliana Mangkuwerdojo: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Erico Mulfiardi: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Radja Buntal Sotarduga Simanjuntak: Medical Doctor - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital
• Made Agus Mahendra Inggas: PhD - Mochtar Riady Comprehensive Cancer Center, Siloam Semanggi Hospital