Inadequate pain management, baseline pain severity linked to pain deterioration
FRIDAY, Dec. 27, 2013 (HealthDay News) -- For ambulatory patients with solid tumors, pain is prevalent and changes over time, according to a study published online Dec. 23 in the Journal of Clinical Oncology.
Fengmin Zhao, Ph.D., from the Dana-Farber Cancer Institute in Boston, and colleagues analyzed patient-rated pain levels (0 to 10 scale) at baseline and four to five weeks later in a cohort of 2,761 ambulatory patients with invasive cancer of the breast, prostate, colon/rectum, or lung from multiple sites. The changes in pain severity were assessed over time, with a clinically significant change in pain defined as a two-point change.
The researchers found that 53.0 percent of patients had no pain, 23.5 percent had mild pain, 10.3 percent had moderate pain, and 13.2 percent had severe pain at initial assessment. Of the patients with initial pain, one-third had pain reduction within one month of follow-up and one-fifth had an increase. Improvement or worsening of pain varied according to the baseline pain score. More than a quarter of the patients without pain at initial assessment (28.4 percent) had pain at follow-up assessment, with 8.9 percent reporting moderate to severe pain. Pain deterioration correlated significantly with inadequate pain management and with lower baseline pain level, younger age, and poor health status.
"In conclusion, pain remains a significant concern in ambulatory oncology," the authors write. "Pain is not only prevalent but also persistent and dynamic."
Abstract (http://jco.ascopubs.org/content/early/2013/12/23/JCO.2013.50.6071.abstract )Full Text (subscription or payment may be required) (http://jco.ascopubs.org/content/early/2013/12/23/JCO.2013.50.6071.full.pdf+html )