TY - JOUR
T1 - Which variables are associated with pain intensity and treatment response in advanced cancer patients? - Implications for a future classification system for cancer pain
AU - Knudsen, Anne Kari
AU - Brunelli, Cinzia
AU - Kaasa, Stein
AU - Apolone, Giovanni
AU - Corli, Oscar
AU - Montanari, Mauro
AU - Fainsinger, Robin
AU - Aass, Nina
AU - Fayers, Peter
AU - Caraceni, Augusto
AU - Klepstad, Pål
AU - European Palliative Care Research Collaborative (EPCRC) and the European Pharmacogenetic Study (EPOS)
N1 - Acknowledgements
This study was supported by the EU’s 6th framework, Contract No. 037777, the Norwegian Research Council, and partially funded by a grant from the Italian Association for Cancer Research (AIRC),IG 9347. Anne Kari Knudsen received a grant from the Central Nor-way Regional Health Authority.
PY - 2011/3
Y1 - 2011/3
N2 - BACKGROUND: This study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain. METHODS: Data from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses. RESULTS: Two thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose. CONCLUSIONS: Breakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.
AB - BACKGROUND: This study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain. METHODS: Data from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses. RESULTS: Two thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose. CONCLUSIONS: Breakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.
KW - assessment
KW - cancer
KW - classification
KW - pain
KW - palliative care
U2 - 10.1016/j.ejpain.2010.08.001
DO - 10.1016/j.ejpain.2010.08.001
M3 - Article
C2 - 20822941
VL - 15
SP - 320
EP - 327
JO - European Journal of Pain
JF - European Journal of Pain
SN - 1090-3801
IS - 3
ER -