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Eur J Pain. 2011 Mar;15(3):320-7. doi: 10.1016/j.ejpain.2010.08.001. Epub 2010 Sep 6.

Which variables are associated with pain intensity and treatment response in advanced cancer patients?--Implications for a future classification system for cancer pain.

Author information

1
European Palliative Care Research Centre, Faculty of Medicine, NTNU, NO-7006 Trondheim, Norway. anne.k.knudsen@ntnu.no

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.

PMID:
20822941
DOI:
10.1016/j.ejpain.2010.08.001
[Indexed for MEDLINE]

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