Abstract
Background: This study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain. Methods: Data from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses. Results: Two thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62 years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341 mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose. Conclusions: Breakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.
| Original language | English |
|---|---|
| Pages (from-to) | 320-327 |
| Number of pages | 8 |
| Journal | European Journal of Pain (United Kingdom) |
| Volume | 15 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2011 |
Fingerprint
Keywords
- Assessment
- Cancer
- Classification
- Pain
- Palliative care
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Which variables are associated with pain intensity and treatment response in advanced cancer patients? - Implications for a future classification system for cancer pain. / Knudsen, Anne Kari; Brunelli, Cinzia; Kaasa, Stein; Apolone, Giovanni; Corli, Oscar; Montanari, Mauro; Fainsinger, Robin; Aass, Nina; Fayers, Peter; Caraceni, Augusto; Klepstad, Pâl.
In: European Journal of Pain (United Kingdom), Vol. 15, No. 3, 03.2011, p. 320-327.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Which variables are associated with pain intensity and treatment response in advanced cancer patients? - Implications for a future classification system for cancer pain
AU - Knudsen, Anne Kari
AU - Brunelli, Cinzia
AU - Kaasa, Stein
AU - Apolone, Giovanni
AU - Corli, Oscar
AU - Montanari, Mauro
AU - Fainsinger, Robin
AU - Aass, Nina
AU - Fayers, Peter
AU - Caraceni, Augusto
AU - Klepstad, Pâl
PY - 2011/3
Y1 - 2011/3
N2 - Background: This study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain. Methods: Data from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses. Results: Two thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62 years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341 mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose. Conclusions: Breakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.
AB - Background: This study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain. Methods: Data from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses. Results: Two thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62 years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341 mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose. Conclusions: Breakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.
KW - Assessment
KW - Cancer
KW - Classification
KW - Pain
KW - Palliative care
UR - http://www.scopus.com/inward/record.url?scp=79952450991&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952450991&partnerID=8YFLogxK
U2 - 10.1016/j.ejpain.2010.08.001
DO - 10.1016/j.ejpain.2010.08.001
M3 - Article
VL - 15
SP - 320
EP - 327
JO - EUR.J.PAIN
JF - EUR.J.PAIN
SN - 1090-3801
IS - 3
ER -