5 years ago

Patient-Reported Outcomes and Opioid Use by Outpatient Cancer Patients

The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category. Eighty-six percent of patients received an opioid at one or more clinic encounters. Regression analysis revealed that being a male or being younger (<=65 yrs. of age) was associated with a greater likelihood of an opioid ordered. Being male nearly doubled the likelihood of a higher dose being ordered than being female. Bivariate analysis found that patients receiving opioids reported significantly more pain relief than no opioid patients. However, patients receiving opioids had higher pain interference scores, lower index of health-state, and more physical distress than no opioid patients Our results identify the need to consider opioid use and dosage when attempting to understand patient reported outcomes (PROs) and factors affecting pain management. Perspective This report describes the results of the analyses of PROs and patient-related electronic health record data collected under standard of care from cancer patients at outpatient pain management clinics of Anesthesiology and Palliative Care at the Memorial Sloan–Kettering Cancer Center. Consideration of sex and age as predictors of opioid use is critical in attempting to understand PROs and their relationship to pain management.

Publisher URL: www.sciencedirect.com/science

DOI: S152659001730771X

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