Pain characteristics and treatment outcome for advanced cancer patients during the first week of specialized palliative care

Strömgren, Annette S; Grøenvold, Mogens; Petersen, Morten Aa.; Goldschmidt, Dorthe; Pedersen, Lise; Spile, Marianne; Irming-Pedersen, Gert; Sjögren, Per

doi:10.1016/j.jpainsymman.2003.06.011

Cited by 85 publications

(71 citation statements)

References 34 publications

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“…These results are similar, in part, to other findings where researchers have found, for example, bone metastases, BTP, and the presence of metastases, associated with higher pain intensity. 13,14,16 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of pain in hospitalised cancer patients in Norway: a national survey

et al. 2007

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Purpose: Pain severely impairs health-related quality of life and is a feared symptom among cancer patients. Unfortunately, patients often do not receive optimal care. We wanted to evaluate the quality of cancer pain treatment in Norwegian hospitals. Patients and methods: A one-day prevalence study targeting hospitalised cancer patients above 18 years of age was performed. A questionnaire based on the Brief Pain Inventory was used, and additional information regarding sex, age, diagnosis, break through pain (BTP), and treatment was included. Results: Fifty two percent of the included patients stated having cancer related pain (n0/453), and mean pain during the previous 24 hours for these patients was NRS 3.99 (Numeric Rating scale 1 Á10). Presence of metastasis, occurrence of BTP, and abnormal skin sensibility in the area of pain were associated with higher pain scores. Forty two percent of all patients used opioids. However, these patients still had higher pain scores, more episodes of BTP, and more influence of the pain on daily life functions than average. Thirty percent of patients with severe pain (NRS]/5) did not use opioids, and some of these patients did not receive any analgesics at all. Conclusion: Although most cancer patients receive an acceptable pain treatment in Norwegian hospitals, there are patients who are not adequately managed. Lack of basic knowledge and individual systematic symptom assessment may be reasons for the underuse of analgesics and the resulting unnecessary suffering among the cancer patients. Palliative Medicine 2007; 21: 7 Á13

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Section: Discussionmentioning

confidence: 99%

Prevalence of pain in hospitalised cancer patients in Norway: a national survey

et al. 2007

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“…For 314 patients admitted to a palliative care ward in Italy over 1 week, pain decreased from an average of 7 to 4 (p < 0.001), as did many other symptoms measured by the Edmonton Symptom Assessment Scale (ESAS) [90]. In another study of 267 cancer patients admitted with pain to a palliative care ward in Denmark and assessed with the ESAS and the European Organization for Research Treatment Cancer Quality of Life Questionnaire, significant decreases were found in pain measures and for other symptoms after 1 week [91]. Pain improvement has also been reported in other settings.…”

Section: Clinical Trialsmentioning

confidence: 97%

Pain and palliative medicine

Chang

Sorger²,

Rosenfeld

et al. 2007

JRRD

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Abstract-Severe pain is highly prevalent, with rates of 40% to 70% in patients with advanced cancer, liver disease, heart failure, human immunodeficiency virus, and renal failure. Wide variations in pain assessment and reporting methods and the measurement of multiple symptoms should be addressed in future studies. Regarding psychological approaches, determining whether hypnotherapy or other individual psychotherapeutic interventions reduce pain and/or psychological distress in a palliative care population is difficult. Interest is increasing in the concept of demoralization syndromes and the role of posttraumatic stress disorder in modulating responses to pain at the end of life. We review evidence from multiple studies that the use of rehabilitative therapy improves functional status and pain control among patients with advanced cancer, and we raise the possibility that rehabilitation therapy will be helpful in patients with other advanced diseases. We summarize ongoing clinical trials of electronic order sets, clinical care pathways, and care management pathways to improve pain management in palliative care. Wagner's Chronic Illness Model provides a way of analyzing how healthcare systems can be changed to provide adequate and continuing pain management in palliative care. Much work remains to ensure that pain is recognized, treated, and monitored effectively.

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“…Factors associated with high pain intensity were neuropathic pain, mixed neuropathic/nociceptive pain etiologies and bone metastases. The authors concluded that there was need for improvement in patients with these categories of pain, both through research and recording of treatment outcomes (20).…”

Section: Cancer-related Neuropathymentioning

confidence: 99%

Prevalence of Neuropathic Pain and the Need for Treatment

Morley-Forster¹

2006

Pain Research and Management

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Recent publications have suggested that more than two million adults in the United States suffer from neuropathic pain, but this number seems to be a significant underestimate. The prevalence of neuropathic pain from diabetes and postherpetic neuralgia alone, using the most conservative estimates of incidence, would equal two million Americans. Lesions of the nervous system responsible for pain genesis can occur either in the central or the peripheral nervous system. The most common causes of peripheral neuropathic pain syndromes worldwide are diabetes, HIV infection, cancer-related neuropathy (due to tumour invasion, surgical nerve damage, radiation or chemotherapy-induced nerve damage) and lumbar degenerative disc disease. Other less common, but significant, sources of suffering are postherpetic neuralgia, complex regional pain syndrome, phantom limb pain and postsurgical nerve trauma. Central neuropathic pain can be caused by stroke (infarct or hemorrhage), multiple sclerosis, spinal cord injury and syringomyelia. Certain pain syndromes such as trigeminal neuralgia and vulvodynia, although clearly neuropathic and a source of tremendous suffering, are not discussed in the present article due to space constraints. There is an unmet need for the treatment of neuropathic pain as evidenced by reports of pain despite the use of opioids and anticonvulsants, continuing psychological difficulties, lack of access to treatments and patients seeking access to complementary therapy.

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Pain characteristics and treatment outcome for advanced cancer patients during the first week of specialized palliative care

Cited by 85 publications

References 34 publications

Prevalence of pain in hospitalised cancer patients in Norway: a national survey

Prevalence of pain in hospitalised cancer patients in Norway: a national survey

Pain and palliative medicine

Prevalence of Neuropathic Pain and the Need for Treatment

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