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Comparison of Indicators for Achievement of Pain Control With a Personalized Pain Goal in a Comprehensive Cancer Center
Authors:Yuki Sumazaki Watanabe  Tomofumi Miura  Ayumi Okizaki  Keita Tagami  Yoshihisa Matsumoto  Maiko Fujimori  Tatsuya Morita  Hiroya Kinoshita
Affiliation:1. Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan;2. Division of Biomarker Discovery, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan;3. Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan;4. Division of Cohort Consortium Research, Epidemiology and Prevention Group/Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan;5. Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Japan;6. Department of Palliative Medicine, Tokatsu Hospital, Nagareyama, Japan
Abstract:

Context

The achievement of a personalized pain goal (PPG) is advocated as an individualized pain relief indicator.

Objectives

Pain relief indicators, including PPG, pain intensity (PI), and interference with daily activities (interference), were compared herein.

Methods

This was a single-center cross-sectional study. Adult patients with cancer on opioid medications who visited the outpatient clinic at the National Cancer Center Hospital East between March and September 2015 were consecutively enrolled. Patients conducted a self-report questionnaire, including reports of average PI, interference, PPG, and the need for further analgesic treatment. We compared the proportion of patients achieving PPG (PI ≤ PPG) and other pain relief indicators including PI ≤3 or interference ≤3 and the percentage of patients who did not need further analgesic treatment among those who fulfilled each pain relief indicator.

Results

A total of 347 patients (median age 64; 38% females) were analyzed. Median (interquartile range [IQR]) of PPG, PI, and interference was 2 (IQR 1–3), 2 (IQR 1–4), and 2 (IQR 0–5), respectively. The proportion of patients achieving PPG was 45.3% and significantly lower than those with PI ≤3 (69.0%; P < 0.001) and interference ≤3 (70.2%; P < 0.001). Eighty percent of patients achieving PPG did not need further analgesic treatment, whereas 70.8% of patients with PI ≤3 (P < 0.001) and 73.3% with interference ≤3 did need further analgesic treatment (P < 0.001).

Conclusion

The achievement of PPG was a stricter pain relief indicator than PI and interference and may reflect a real need for pain control.
Keywords:Personalized pain goal  cancer pain  pain management
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