Wilkie DJ, Yao Y, Ezenwa MO, et al. - Researchers investigated how usual hospice care vs PAINRelieveIt influence pain outcomes in patients with cancer and their lay caregivers. In a 5-step, stepped wedge randomized, controlled study, 234 patients (49% male, 18% Hispanic, 51% racial minorities) and 231 lay caregivers (26% male, 20% Hispanic, 54% racial minorities) were provided usual hospice care with intervention components that incorporated a summary of the patient’s pain data, decision support for hospice nurses, and multimedia education tailored to the patient’s and lay caregiver’s misconceptions about pain. Analgesic adherence (primary outcome) did not influence significantly following the implementation of the intervention. The experimental group had significantly higher posttest worst pain intensity, but the difference was not clinically meaningful. Nearly universal availability of prescriptions for strong opioids and adjuvant analgesics for neuropathic pain was reported in both groups. Relative to lay caregivers in the usual care group, those in the experimental group reported significantly lower pain misconceptions (0-5 scale). The trial clearly illustrates the feasibility of implementing the innovative set of interventions.