Patient-reported outcome measures (PROMs) and palliative-care clinician reported outcomes (ClinROs) mutually improve pain and other symptoms assessment of hospitalized cancer-patients

Jonas Sørensen; Per Sjøgren; Clemmensen Stine; Tanja Vibeke Sørensen; Katja Heinecke; Henrik Larsen; Inge Eidemak; Geana Paula Kurita

doi:10.1515/sjpain-2021-0162

Patient-reported outcome measures (PROMs) and palliative-care clinician reported outcomes (ClinROs) mutually improve pain and other symptoms assessment of hospitalized cancer-patients

Scand J Pain. 2022 Feb 17;22(3):569-577. doi: 10.1515/sjpain-2021-0162. Print 2022 Jul 26.

Authors

Jonas Sørensen¹, Per Sjøgren^{1

2}, Clemmensen Stine^{3

1

2}, Tanja Vibeke Sørensen¹, Katja Heinecke¹, Henrik Larsen¹, Inge Eidemak¹, Geana Paula Kurita^{1

2

4}

Affiliations

¹ Department of Oncology, Section of Palliative Medicine, Rigshospitalet, Copenhagen, Denmark.
² Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
³ Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
⁴ Department of Oncology and Multidisciplinary Pain Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

PMID: 35179007
DOI: 10.1515/sjpain-2021-0162

Abstract

Objectives: Patients with malignant diseases are known to have a high symptom burden including pain, and insufficient treatment of pain in this population has been frequently documented. To promote the integration of specialized palliative care and hematology and oncology, this study investigated disease, treatment, and comorbidity related symptoms as well as functional capacity and health-related quality of life (HQoL) by patient-reported outcome measures (PROMs) and clinician-reported outcome measures (ClinROs) among inpatients in a comprehensive cancer center.

Methods: This cross-sectional study was carried out in a large comprehensive cancer centre of both oncological and hematological inpatients. It combined the use of PROMs and ClinROs.

Results: A high symptom burden was reported with fatigue and appetite loss as the most frequent symptoms, and role function being the most impaired function. Further, a low HQoL score was associated with a high number of symptoms/impairments. More than half of all patients reported pain in the last 24 h. Out of 95 patients with average pain >0 in the last 24 h, 71% were treated with opioids and 24% were treated with adjuvant analgesic (AA) defined as antiepileptics, antidepressants and prednisolone. Out of 57 patients with average pain >0 in the last 24 h and possible neuropathic pain, 33% were treated with AAs. A high odds ratio for moderate/severe pain in patients with possible neuropathic pain mechanisms was observed.

Conclusions and implications: This study did not only emphasize the need for systematic use of PROMs to identify symptoms and needs for inpatients, but also displayed why PROMs supported by ClinROs are a prerequisite to deliver truly individualized and high-quality patient-centered care. This study calls for continuous training of health care professionals to deliver high-quality treatment of pain. Further, it contributes to the growing recognition, that palliative care and standard care must be integrated to strengthen patient-centered care.

Keywords: cancer pain; neuralgia; pain measurement; patient reported outcome measures; quality of life; symptom assessment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Neoplasms* / complications
Neoplasms* / therapy
Neuralgia* / complications
Palliative Care
Patient Reported Outcome Measures
Quality of Life