Pain and other symptoms and their relationship to quality of life in cancer patients on opioids
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The purpose of this study was to assess pain, other symptoms and QOL, and the relationship between these variables, among cancer patients on strong opioids.
The study was cross-sectional, descriptive, and correlational. A convenience sample of 150 cancer patients, ≥18 years, all on strong opioids for ≥3 days was recruited.
The mean (SD) age was 64.7 (12.7) years, and 59 % were women. Mean (SD) time from cancer diagnosis was 36.3 (55.1) months. The median number of symptoms was 9, range 1–16 and the mean (SD) severity was 1.9 (0.5) on a 1–4 scale. Pain was one of the most prevalent (90 %) and severe symptoms with a mean (SD) of 2.56 (0.9). Number of symptoms explained 25.8 % of the variance in QOL, adjusted for age and sex. Another model, also adjusted for age and sex, showed that pain, fatigue, insomnia and depression, explained 33.6 % of the variance in QOL.
The symptomatology in this study was similar to studies on patients with advanced cancer. QOL was associated with the number of symptoms patients experience and individual symptoms, notably fatigue and pain. Despite the use of strong opioids, pain was both common and severe, suggesting under-treatment. Pain and other symptoms need to be assessed and managed in order to improve patients’ QOL. Special attention needs to be paid to multisymptom management in patients on opioids.
KeywordsCancer Pain Symptoms Quality of life Opioids EORTC QLQ-C30
We owe our gratitude to Gudbjorg Jona Gudlaugsdottir, research nurse, for her impressive work during data collection. The study received grants from the following institutions/funds: 1. The Icelandic Research Fund for Graduate Students. 2. University of Iceland Research Fund. 3. Landspitali University Hospital Research Fund. 4. The Icelandic Nurses Association Research Fund. 5. The Icelandic Cancer Society Research Fund. 6. Bergþóra Magnúsdóttir and Jakob J. Bjarnason Memorial Fund. 7. The Memorial Fund of the Palliative Unit at the Landspitali University Hospital. 8. The Scientific Fund of the Oncology Unit of the Landspitali University Hospital.
Conflict of interest
The authors declare that they have nothing to disclose. The study sponsors had no role in the study design, data collection, or in the writing or decision to submit the manuscript for publication.
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