Pain and its treatment in hospitalized patients with metastatic cancer

Cascinu, Stefano; Giordani, Paolo; Agostinelli, Romina; Gasparini, Giampietro; Barni, Sandro; Beretta, Giordano Domenico; Pulita, Franca; Iacorossi, Laura; Gattuso, Domenico; Mare, Marzia; Munaò, Stefania; Labianca, Roberto; Todeschini, Renata; Camisa, Roberta; Cellerino, R; Catalano, Giuseppina

doi:10.1007/s00520-003-0491-3

Cited by 36 publications

(35 citation statements)

References 20 publications

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“…However, a recent survey taken from 120 consecutive patients in six oncology centers suggests that the medical oncology trend is to underestimate and undertreat pain [4]. We can hypothesize that in Italy there is a gap between what the physicians "know" and what they actually "do" in their daily practice.…”

Section: Discussionmentioning

confidence: 90%

Pain evaluation and management: a survey of Italian radiotherapists

Porzio

Valenti

Aielli

et al. 2004

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Section: Discussionmentioning

confidence: 90%

Pain evaluation and management: a survey of Italian radiotherapists

Porzio

Valenti

Aielli

et al. 2004

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“…Patients with non-small cell lung cancer undergoing three different protocols of chemotherapy, 82 % of patients had negative PMI scores and were considered poorly managed, according to the class drug-pain intensity ratio [11]. In another Italian survey performed in hospitalized patients, analgesic prescription was found to be inadequate in 43 % of cases [5]. In a large survey performed in Italy about the prevalence of pain and its treatment of a cancer population referring to the majority of oncologic centers, it has been found that about 85 % of patients had their pain uncontrolled, despite receiving opioids [18].…”

Section: Discussionmentioning

confidence: 99%

“…Pain management index (PMI) was calculated to make a historical comparison with previous other epidemiological studies [1,5,9,25], where this tool was used as a surrogate of appropriateness of pain management.…”

Section: Methodsmentioning

confidence: 99%

“…Of the 385 screened patients, 266 patients (69.1 %) had no pain, 74(19.2 %) had mild pain intensity, 33 patients (8.6 %) had moderate pain [5,6], and 12 patients (3.1 %) had severe pain intensity (≥7-10). There was no relationship between the four pain groups and age (p=0.900), gender (p=0.882), type of admission (p=0.220), previous surgery (p=0.112), and ongoing chemotherapy (p=0.174).…”

Section: Pain Prevalencementioning

confidence: 99%

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

Mercadante

Guccione

Fatta

et al. 2013

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“…However, the doses of analgesics used were still lower than those generally recommended and more than one third of the physicians were not familiar with the WHO analgesic ladder [5]. Symptoms that impair the quality of life of cancer patients are still underestimated [6] with significant differences in the ratings of the symptoms between the physician and the patient [7,8].…”

Section: Introductionmentioning

confidence: 99%

How palliative care of cancer patients is organised between a University Hospital and primary care in Finland

2006

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The aim of this study was to find out how palliative care is organised between the Helsinki University Central Hospital (University Hospital) and primary care. The study consisted of 102 patients whose oncological treatment was terminated and the responsibility of palliative care was transferred to primary care. The patients were interviewed by phone using a structured questionnaire. Another questionnaire form was sent to the primary care physicians. Half of the patients were treated in more than one primary care unit. One third of the outpatients were unaware who was responsible for the care. Most of the patients wanted to be at home but this was achieved in less than half of the cases. Most patients were symptomatic while leaving the University Hospital and no improvement was seen thereafter. Every third patient reported of poor quality of palliative care in the primary care. Also the physicians reported a need for training in palliative care.Palliative medicine refers to the management of patients with an active, far-advanced disease the prognosis of which is limited and the focus of care is in the quality of life [1]. The World Health Organization (WHO) has defined palliative care as being the active total care of patients whose disease is not responsive to curative treatment [2].The treatment of cancer pain has achieved much attention during the last decades. It has been one of the areas of interest for WHO. In Finland treatment strategies of cancer pain were studied in 1985, 1990 and in 1995 [3Á/5]. Between these studies significant improvement in cancer pain management took place. However, the doses of analgesics used were still lower than those generally recommended and more than one third of the physicians were not familiar with the WHO analgesic ladder [5]. Symptoms that impair the quality of life of cancer patients are still underestimated [6] with significant differences in the ratings of the symptoms between the physician and the patient [7,8].Approximately 10 000 cancer patients die annually, but there are only a few specialised palliative care units in Finland. The Finish health care system is based on a strong primary health care organisation. University hospitals have had a general trend to reduce treatment periods in hospitals and to transfer the palliative care of the cancer patients from the specialists to GPs. The GPs treat cancer patients in outpatient clinics, inpatient wards and home-hospitals of the health centres, in home care teams and in acute hospitals. In addition, there are hospices maintained by private foundations in Finland. For the palliative care outpatients only the hospices and the home-hospitals provide help with symptom control around-the-clock and seven days a week. The other outpatients in palliative care can use the general public primary health care services, among others the emergency units. The patients in primary care can be referred back to the University Hospital only in very specific problems, for example if palliative radiotherapy or invasive methods of...

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Pain and its treatment in hospitalized patients with metastatic cancer

Cited by 36 publications

References 20 publications

Pain evaluation and management: a survey of Italian radiotherapists

Pain evaluation and management: a survey of Italian radiotherapists

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

How palliative care of cancer patients is organised between a University Hospital and primary care in Finland

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