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Cancer Pain Outcome Research Study Group (CPOR SG) Investigators 4
| Citations: | 2 - 0 self |
BibTeX
@MISC{Apolone_cancerpain,
author = {G Apolone and O Corli and A Caraceni and E Negri and S De and M Montanari},
title = {Cancer Pain Outcome Research Study Group (CPOR SG) Investigators 4},
year = {}
}
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Abstract
Most patients with advanced or metastatic cancer experience pain and despite several guidelines, undertreatment is well documented. A multicenter, open-label, prospective, non-randomised study was launched in Italy in 2006 to evaluate the epidemiology, patterns and quality of pain care of cancer patients. To assess the adequacy of analgesic care, we used a standardised measure, the pain management index (PMI), that compares the most potent analgesic prescribed for a patient with the reported level of the worst pain of that patient together with a selected list of clinical indicators. A total of 110 centres recruited 1801 valid cases. 61 % of cases were received a WHO-level III opioid; 25.3 % were classified as potentially undertreated, with wide variation (9.8– 55.3%) according to the variables describing patients, centres and pattern of care. After adjustment with a multivariable logistic regression model, type of recruiting centre, receiving adjuvant therapy or not and type of patient recruited (new or already on followup) had a significant association with undertreatment. Non-compliance with the predefined set of clinical indicators was generally high, ranging from 41 to 76%. Despite intrinsic limitations of the PMI that may be considered as an indicator of the poor quality of cancer pain care, results suggest that the recourse to WHO third-level drugs still seems delayed in a substantial percentage of patients. This delay is probably related to several factors affecting practice in participating centres and suggests that the quality of
Keyphrases
cpor sg clinical indicator several guideline wide variation pain management index predefined set valid case pain care adjuvant therapy intrinsic limitation poor quality third-level drug substantial percentage several factor metastatic cancer experience pain non-randomised study cancer pain care standardised measure significant association who-level iii opioid potent analgesic prescribed selected list cancer patient multivariable logistic regression model analgesic care
