Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit

Support Care Cancer. 2013 Dec;21(12):3287-92. doi: 10.1007/s00520-013-1899-z. Epub 2013 Jul 26.

Abstract

Background: This survey was performed to draw information on pain prevalence, intensity, and management from a sample of patients who were admitted to an oncologic center where a palliative care unit (PCU) has been established for 13 years.

Methods: Cross-sectional survey in an oncological department performed 1 day per month for six consecutive months.

Results: Of the 385 patients, 69.1, 19.2, 8.6, and 3.1 % had no pain, mild, moderate, and severe pain, respectively. Inpatients and patients with a low Karnofsky score showed higher levels of pain intensity (p < 0.0005). One hundred twenty-eight patients with pain or receiving analgesics were analyzed for pain management index (PMI). Only a minority of patients had negative PMI score, which was statistically associated with inpatient admission (p = 0.011). Fifty of these 128 patients had breakthrough pain (BTP), and all of them were receiving some medication for BTP.

Conclusion: It is likely that the presence of PCU team providing consultation, advices, and cultural pressure, other than offering admissions for difficult cases had a positive impact on the use of analgesics, as compared with previous similar surveys performed in oncological setting, where a PCU was unavailable. This information confirms the need of the presence of a PCU in a high volume oncological department.

MeSH terms

  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Breakthrough Pain / drug therapy
  • Breakthrough Pain / etiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Pain / drug therapy*
  • Pain / etiology*
  • Pain Management / methods*
  • Pain Measurement
  • Palliative Care / methods*
  • Prevalence
  • Young Adult

Substances

  • Analgesics