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Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit

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Abstract

Background

This survey was performed to draw information on pain prevalence, intensity, and management from a sample of patients who were admitted to an oncologic center where a palliative care unit (PCU) has been established for 13 years.

Methods

Cross-sectional survey in an oncological department performed 1 day per month for six consecutive months.

Results

Of the 385 patients, 69.1, 19.2, 8.6, and 3.1 % had no pain, mild, moderate, and severe pain, respectively. Inpatients and patients with a low Karnofsky score showed higher levels of pain intensity (p < 0.0005). One hundred twenty-eight patients with pain or receiving analgesics were analyzed for pain management index (PMI). Only a minority of patients had negative PMI score, which was statistically associated with inpatient admission (p = 0.011). Fifty of these 128 patients had breakthrough pain (BTP), and all of them were receiving some medication for BTP.

Conclusion

It is likely that the presence of PCU team providing consultation, advices, and cultural pressure, other than offering admissions for difficult cases had a positive impact on the use of analgesics, as compared with previous similar surveys performed in oncological setting, where a PCU was unavailable. This information confirms the need of the presence of a PCU in a high volume oncological department.

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Disclosures

This paper did not receive any support. The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Anesthesia & Intensive Care and Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, and Palliative Medicine, University of Palermo, Via S. Lorenzo 312, 90145, Palermo, Italy

    Sebastiano Mercadante, Giovanna Prestia & Rosanna Bellingardo

  2. Faculty of Pharmacy, University of Palermo, Palermo, Italy

    Costanza Guccione

  3. Medical School, University of Palermo, Palermo, Italy

    Simona Di Fatta

  4. Anesthesia and Intensive Care Unit, Ospedale Giglio, Cefalù, Italy

    Sebastiano Mercadante, Valentina Alaimo & Antonino Giarratano

  5. Department of Oncology, La Maddalena Cancer Center, Palermo, Italy

    Vittorio Gebbia

  6. Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy

    Alessandra Casuccio

  7. Chair of Anesthesiology, University of Palermo, Palermo, Italy

    Sebastiano Mercadante, Valentina Alaimo & Antonino Giarratano

Authors
  1. Sebastiano Mercadante
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  2. Costanza Guccione
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  3. Simona Di Fatta
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  4. Valentina Alaimo
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  5. Giovanna Prestia
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  6. Rosanna Bellingardo
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  7. Vittorio Gebbia
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  8. Antonino Giarratano
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  9. Alessandra Casuccio
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Correspondence to Sebastiano Mercadante.

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Mercadante, S., Guccione, C., Di Fatta, S. et al. Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit. Support Care Cancer 21, 3287–3292 (2013). https://doi.org/10.1007/s00520-013-1899-z

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  • DOI: https://doi.org/10.1007/s00520-013-1899-z

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