Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit.

Mercadante S, Guccione C, Di Fatta S, Alaimo V, Prestia G, Bellingardo R, Gebbia V, Giarratano A, Casuccio A.

Source

Anesthesia & Intensive Care and Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, and Palliative Medicine, University of Palermo, Via S. Lorenzo 312, 90145, Palermo, Italy, terapiadeldolore@lamaddalenanet.it.

Abstract

BACKGROUND:

This survey was performed to draw information on pain prevalence, intensity, and management from a sample of patients who were admitted to an oncologic center where a palliative care unit (PCU) has been established for 13 years.

METHODS:

Cross-sectional survey in an oncological department performed 1 day per month for six consecutive months.

RESULTS:

Of the 385 patients, 69.1, 19.2, 8.6, and 3.1 % had no pain, mild, moderate, and severe pain, respectively. Inpatients and patients with a low Karnofsky score showed higher levels of pain intensity (p < 0.0005). One hundred twenty-eight patients with pain or receiving analgesics were analyzed for pain management index (PMI). Only a minority of patients had negative PMI score, which was statistically associated with inpatient admission (p = 0.011). Fifty of these 128 patients had breakthrough pain (BTP), and all of them were receiving some medication for BTP.

CONCLUSION:

It is likely that the presence of PCU team providing consultation, advices, and cultural pressure, other than offering admissions for difficult cases had a positive impact on the use of analgesics, as compared with previous similar surveys performed in oncological setting, where a PCU was unavailable. This information confirms the need of the presence of a PCU in a high volume oncological department.

 Support Care Cancer. 2013 Jul 26.