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Determinants of pain severity changes in ambulatory patients with cancer: an analysis from Eastern Cooperative Oncology Group trial E2Z02.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2014 Feb 01; Vol. 32 (4), pp. 312-9. Date of Electronic Publication: 2013 Dec 23. - Publication Year :
- 2014
-
Abstract
- Purpose: To understand changes in pain severity over time and to explore the factors associated with pain changes in ambulatory patients with solid tumors.<br />Patients and Methods: We enrolled 3,106 patients with invasive cancer of the breast, prostate, colon/rectum, or lung from multiple sites. At baseline and 4 to 5 weeks later, patients rated their pain level on a 0 to 10 numerical rating scale. A 2-point change in pain score was defined as a clinically significant change in pain. Multivariable logistic models were fitted to examine the effects of pain management and demographic and clinical factors on change in pain severity.<br />Results: We analyzed 2,761 patients for changes in pain severity. At initial assessment, 53.0% had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain. Overall, one third of patients with initial pain had pain reduction within 1 month of follow-up, and one fifth had an increase, and the improvement and worsening of pain varied by baseline pain score. Of the patients without pain at initial assessment, 28.4% had pain (8.9% moderate to severe) at the follow-up assessment. Logistic regression analysis showed that inadequate pain management was significantly associated with pain deterioration, as were lower baseline pain level, younger age, and poor health status.<br />Conclusion: One third of patients have pain improvement and one fifth experience pain deterioration within 1 month after initial assessment. Inadequate pain management, baseline pain severity, and certain patient demographic and disease characteristics are associated with pain deterioration.
- Subjects :
- Adult
Aged
Breast Neoplasms complications
Colorectal Neoplasms complications
Female
Humans
Logistic Models
Lung Neoplasms complications
Male
Middle Aged
Multivariate Analysis
Pain Management methods
Pain Management standards
Pain Measurement
Prostatic Neoplasms complications
Risk Factors
Severity of Illness Index
Time Factors
Ambulatory Care standards
Neoplasms complications
Pain diagnosis
Pain etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 32
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 24366929
- Full Text :
- https://doi.org/10.1200/JCO.2013.50.6071