Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients

J Palliat Med. 2015 Nov;18(11):923-32. doi: 10.1089/jpm.2015.29002.jps. Epub 2015 Jul 28.

Abstract

Background: Pain in cancer patients is recognized as a major health problem, yet few studies of both inpatient and outpatient populations have been carried out.

Objective: The study objective was to assess the frequency, type, and characteristics of pain in adult cancer patients, including both inpatients and outpatients.

Methods: This cross-sectional study involved 1064 adult cancer patients (437 outpatients and 627 inpatients) from 44 hospitals and/or long-term-care centers in Catalonia, Spain. Cancer patients suffering from pain of any etiology for ≥2 weeks and/or under analgesic treatment ≥2 weeks were enrolled. Demographic and pain data were collected. The Spanish version of the Brief Pain Inventory was used to assess pain.

Results: Pain frequency was 55.3%. Pain was less frequent in outpatients than inpatients (41.6% versus 64.7%; p<0.001), although median pain duration was longer in outpatients (20 versus 6 weeks; p<0.001). Pain was assessable in 333 patients, and intensity was similar in both out- and inpatients; however, outpatients reported less improvement, less pain interference with daily life, and less pain related to the cancer per se. In both groups, patients with multiple myeloma (73%), breast (65%), and lung cancer (61%) were most likely to report pain.

Conclusions: Pain in cancer patients, both ambulatory and hospitalized, remains a challenge for health care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, a problem that is particularly notable in outpatients due to the intensity and duration of the pain.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Outpatients / statistics & numerical data
  • Pain / classification
  • Pain / epidemiology
  • Pain / etiology*
  • Pain Management / methods
  • Pain Management / standards*
  • Pain Measurement
  • Prevalence
  • Sex Distribution
  • Spain / epidemiology
  • Young Adult