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How does pain experience relate to the need for pain relief? A secondary exploratory analysis in a large sample of cancer patients

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Abstract

Purpose

To explore (1) the information obtained from related but conceptually different approaches to pain assessment and (2) the extent to which the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) can be used as a screening tool to predict patient-reported need for pain relief.

Methods

Cancer patients randomly sampled from 56 hospital departments were included. Questionnaire items assessed patients’ (a) pain experience using the EORTC QLQ-C30 pain scale and its two pain items separately (pain intensity and pain interference) and (b) pain burden and (c) need for pain relief using the Three-Levels-of-Needs Questionnaire (3LNQ).

Results

Of the 2364 patients contacted by mail, 1447 (61 %) completed the questionnaires. Among these, 51 % reported at least “a little” pain on the pain intensity item. The number of patients reporting pain to be a burden was similar, and pain experience and pain burden were highly correlated (correlation coefficients ranged from 0.85 to 0.91). Pain experience and pain burden were moderately correlated with the need for pain relief. A receiver-operating characteristic (ROC) curve analysis showed that the EORTC QLQ-C30 discriminated between patients with and without a need for pain relief to an acceptable degree (area under the curve (AUC) 0.73–0.77). The cut-point a little gave a sensitivity of 84 % and specificity of 59 % for the item “Have you had pain?” and a sensitivity of 72 % and a specificity of 72 % for the pain scale.

Conclusions

The majority of patients who experienced pain felt it to be a problem. Pain experience and pain burden were substantially related to need for pain relief, and the latter could be predicted from the EORTC QLQ-C30.

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Acknowledgments

We wish to thank the patients participating in the study. The study was supported by the Danish Cancer Society (PP01006, PP05033, and PP07031) and the Ministry of Health’s Grant for Development and Analysis (2003-0201-39).

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Authors and Affiliations

  1. The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital 20D, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    Anna Thit Johnsen, Morten A. Petersen, Lise Pedersen & Mogens Groenvold

  2. Department of Psychology, University of Southern Denmark, Odense, 5230, Denmark

    Anna Thit Johnsen

  3. Department of Medicine, Johns Hopkins University School of Medicine, 624 N Broadway, Baltimore, MD, USA

    Claire F. Snyder

  4. Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark

    Mogens Groenvold

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  1. Anna Thit Johnsen
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  2. Morten A. Petersen
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  3. Claire F. Snyder
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  4. Lise Pedersen
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  5. Mogens Groenvold
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Corresponding author

Correspondence to Anna Thit Johnsen.

Ethics declarations

The authors declare that they have no conflict of interest. The funding source did not have any involvement in study design, data collection, analysis and interpretation, or in the dissemination of results.

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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There are no conflicts of interest for any of the authors.

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Johnsen, A.T., Petersen, M.A., Snyder, C.F. et al. How does pain experience relate to the need for pain relief? A secondary exploratory analysis in a large sample of cancer patients. Support Care Cancer 24, 4187–4195 (2016). https://doi.org/10.1007/s00520-016-3246-7

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  • DOI: https://doi.org/10.1007/s00520-016-3246-7

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