Quality of cancer pain management: An update of a systematic review of undertreatment of patients with cancer

Maria Teresa Greco, Anna Roberto, Oscar Corli, Silvia Deandrea, Elena Bandieri, Silvio Cavuto, Giovanni Apolone

Research output: Contribution to journalArticle

Abstract

Purpose: Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent. Methods: We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4% of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses. Results: In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25% (from 43.4 to 31.8%). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion: Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.

Original languageEnglish
Pages (from-to)4149-4154
Number of pages6
JournalJournal of Clinical Oncology
Volume32
Issue number36
DOIs
Publication statusPublished - Dec 20 2014

Fingerprint

Pain Management
Neoplasms
Pain
MEDLINE
Opioid Analgesics
Observational Studies
Analgesics
Economics
Cancer Pain
Guidelines

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Quality of cancer pain management : An update of a systematic review of undertreatment of patients with cancer. / Greco, Maria Teresa; Roberto, Anna; Corli, Oscar; Deandrea, Silvia; Bandieri, Elena; Cavuto, Silvio; Apolone, Giovanni.

In: Journal of Clinical Oncology, Vol. 32, No. 36, 20.12.2014, p. 4149-4154.

Research output: Contribution to journalArticle

Greco, Maria Teresa ; Roberto, Anna ; Corli, Oscar ; Deandrea, Silvia ; Bandieri, Elena ; Cavuto, Silvio ; Apolone, Giovanni. / Quality of cancer pain management : An update of a systematic review of undertreatment of patients with cancer. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 36. pp. 4149-4154.
@article{fe8de3d3b000461eb02e47a0f5fd5ca7,
title = "Quality of cancer pain management: An update of a systematic review of undertreatment of patients with cancer",
abstract = "Purpose: Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent. Methods: We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4{\%} of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses. Results: In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25{\%} (from 43.4 to 31.8{\%}). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion: Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.",
author = "Greco, {Maria Teresa} and Anna Roberto and Oscar Corli and Silvia Deandrea and Elena Bandieri and Silvio Cavuto and Giovanni Apolone",
year = "2014",
month = "12",
day = "20",
doi = "10.1200/JCO.2014.56.0383",
language = "English",
volume = "32",
pages = "4149--4154",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "36",

}

TY - JOUR

T1 - Quality of cancer pain management

T2 - An update of a systematic review of undertreatment of patients with cancer

AU - Greco, Maria Teresa

AU - Roberto, Anna

AU - Corli, Oscar

AU - Deandrea, Silvia

AU - Bandieri, Elena

AU - Cavuto, Silvio

AU - Apolone, Giovanni

PY - 2014/12/20

Y1 - 2014/12/20

N2 - Purpose: Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent. Methods: We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4% of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses. Results: In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25% (from 43.4 to 31.8%). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion: Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.

AB - Purpose: Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent. Methods: We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4% of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses. Results: In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25% (from 43.4 to 31.8%). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion: Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.

UR - http://www.scopus.com/inward/record.url?scp=84919706261&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84919706261&partnerID=8YFLogxK

U2 - 10.1200/JCO.2014.56.0383

DO - 10.1200/JCO.2014.56.0383

M3 - Article

C2 - 25403222

AN - SCOPUS:84919706261

VL - 32

SP - 4149

EP - 4154

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 36

ER -