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Impact and predictive factor of undertreatment of analgesic drug in outpatients with cancer: a nationwide of clinical pain survey in Taiwan

Date

21 Dec 2015

Session

Supportive and palliative care

Presenters

Chan-Keng Yang

Citation

Annals of Oncology (2015) 26 (suppl_9): 111-124. 10.1093/annonc/mdv531

Authors

C. Yang1, W. Chou2, W. Shen2, J. Chen2, K. Lee3, C. Yen4, P. Lai5, Y. Shao6, W. Hwang7, T. Chiou8, Y. Sung9, K. Rau10, Y. Liao11, C.S. Chang12, M. Wu13, M. Lee14, M. Yu15, T. Liu16, R. Hsieh17

Author affiliations

  • 1 Division Of Hematology-oncology, Department Of Internal Medicine, Chang Gung Memorial Hospital-Linkou, 333 - Taoyuan/TW
  • 2 Division Of Hematology-oncology, Department Of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Taoyuan/TW
  • 3 Hematology And Oncology, Chiayi Chang Gung Memorial Hospital, Chiayi/TW
  • 4 Hematology And Oncology, National Cheng Kung University Hospital, Tainan/TW
  • 5 Hematology And Oncology, E-DA Hospital, Kaohsiung/TW
  • 6 Oncology, National Taiwan University Hospital, Taipei/TW
  • 7 Hematology And Oncology, Taichung Veterans General Hospital, Taichung/TW
  • 8 Hematology And Oncology, Taipei Veterans General Hospital, Taipei/TW
  • 9 Hematology And Oncology, Cathay General Hospital, Taipei/TW
  • 10 Hematology And Oncology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung/TW
  • 11 Hematology And Oncology, China Medical University Hospital, 404 - Taichung/TW
  • 12 Hematology-oncology, Changhua Christian Hospital Cancer Research Center, Changhua City/TW
  • 13 Oncology, Chung Shan Medical University Hospital Da-Ching, Taichung/TW
  • 14 Hematology And Oncology, Chia Yi Christian Hospital, Chiayi/TW
  • 15 Hematology And Oncology, Kaohsiung Veterans General Hospital, Kaohsiung/TW
  • 16 Hematology And Oncology, Chung-Ho Memorial Hospital,Kaohsiung Medical University Hospital, Kaohsiung/TW
  • 17 Hematology And Oncology, Mackay Memorial Hospital, Taipei/TW
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Abstract 1138

Aim/Background

This study is part of multi-center clinical survey on satisfaction of pain management in patients with cancer in Taiwan. The purpose was going to explore the impact of quality of life and factors relevant to undertreatment of analgesic agents in Taiwanese outpatients with cancer.

Methods

The outcome questionnaire of this study was based on the Brief Pain Inventory (BPI). The BPI asked patients to rate their current pain intensity and also pain in the last 7 days at its worst, least, and average. Patients were also asked to rate the extent to which their pain interfered with 7 quality of-life (QoL) domains, and to rate the satisfaction of pain control to the physician and the analgesic drugs. The Pain management index (PMI) was computed by subtracting the pain level from the analgesic level.

Results

A total of 2,652 outpatients who age 20 or older diagnosed with cancer were enrolled. The mean age were 57 (range 20-95) years, while 56% were male. 62.6% patients had ever pain within last week at the time of assessment. 32.4% patients was the negative PMI. Patients with negative PMI score had significant poor outcome at all of 7 QoL domains (all p values < 0.001) and also had a significantly higher scale toward dissatisfaction of pain control to the physician (1.92 vs 1.73, p = 0.038) and to the analgesic drugs (1.96 vs 1.77, p = 0.039). Gender (female vs male: 55.9% vs 75.7%, odds ratio [OR] 0.41, 95% CI 0.33-0.50, p <0.001), primary tumor site (breast vs hematology: 45.5% vs 66.1%, OR 0.43, 95% CI 0.29-0.63, p <0.001), cause of pain (noncancer-related vs cancer-related: 58.1% vs 72.5%, OR 0.51, 95% CI 0.40-0.64, p <0.001) and hospital locations(south Taiwan vs north Taiwan: 76.5% vs 56.4%, OR 2.52, 95% CI 1.97-3.22, p < 0.001) were independent variables that predicated patients with positive PMI.

Conclusions

Patients with negative PMI had significant poor outcome at all of 7 QoL domains. In addition, negative PMI with a significantly higher scale toward dissatisfaction of pain control and the analgesic drugs. Patients who being female, breast cancer, noncancer-related pain, and patients at north Taiwan had the lower probability of being a positive PMI.

Clinical trial identification

Chang Gung Medical Foundation IRB: 102-5775B; 2014-3-28 to 2015-3-27

Disclosure

All authors have declared no conflicts of interest.

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