1425P - Pain management in eight Italian oncological care centres

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Palliative Care
Presenter Sandro Barni
Authors S. Barni1, K.F. Borgonovo2, F. Di Costanzo3, F. Cognetti4, G. Bernardo5, C. Boni6, B. Agostara7, P. Pronzato8, G. Colucci9, M. Mammucari10
  • 1Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 2Oncologia Medica E Chemioterapia, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 3Azienda Ospedaliero Universitaria Careggi, 50134 - Firenze/IT
  • 4Division Medical Oncology A, Istituto Regina Elena, IT-00144 - Roma/IT
  • 5Oncologia Medica 2, Fondazione S. Maugeri IRCCS, IT-27100 - Pavia/IT
  • 6Oncology Dept., Arcispedale S. Maria NuovaDivisione di Oncologia, IT-42100 - Reggio Emilia/IT
  • 7Oncology Division, A.O. Civico Palermo, PALERMO/IT
  • 8Oncologia Medica A, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 9Oncology Division, Istituto Tumori Ospedale Oncologico, Bari/IT
  • 10Rmf, RMF, roma/IT

Abstract

Introduction

Management of oncologic patients is different between treating centers, and in particular management of pain. We decided to perform a retrospective study to explore different approaches to oncological painful patients (pts) in different Italian Cancer Units.

Materials and methods

We evaluated in 8 Italian cancer hospitals all consecutive pts during 5 days in order to investigate level of pain in the previous 7 days and in the following two weeks from the basal visit. Patients and oncologists filled up a questionnaire (type of pain, intensity, site of pain, and analgesic therapy).

Results

265 pts were enrolled, 59% female and 41% male; median age 61.5. 88% of pts had ECOG PS 0-1; 72.8% of pts reported metastatic disease and 86.4% were under chemotherapy treatment. Pain measured with VAS (Visual Analogic Scale) at baseline was 2.9. Pain was somatic in 32.4%, visceral in 12.5% visceral, 13.9% neuropathic, 41.2% mixed. The current analgesic therapy at baseline had been prescribed by oncologist in 38.2%, by other specialist in 42.1%, by family doctor in 18.5% and by other doctor in 1.1%. The basal analgesic treatment was confirmed in 57.3%, adjusted in 34%, and changed in 8.6%. At baseline we detected NSAIDS in 69.4% pts, weak opioids in 34% of pts; strong opioids in 38.9%, and 27.7% of pts also had adjuvants (24.5% pregabalin, 57.1% steroids, 18.4% other drugs). At first weekly follow-up (216 pts) the intensity of pain was 2.6 (VAS). The analgesic therapy was confirmed in 72.2% and adjusted in 27.8%. New drugs prescribed at first follow-up were NSAIDS in 43.3%, weak opioids in 21.7%, strong opioids in 86.7%, adjuvants in 55%. At second weekly follow-up (131 pts): 80.9% of therapies were confirmed and 19.1% adjusted. 90.3% therapies of 72 pts coming to third follow-up were confirmed. In 85.7% of the adjusted therapies an adjuvant was prescribed.

Conclusions

Our data suggest two important comments. First, we observed a poor utilization of adjuvants by physicians in oncologic patients, especially when therapies are not prescribed by oncologists. Second, our data confirmed the need for a close follow-up to improve analgesic therapy.

Disclosure

All authors have declared no conflicts of interest.