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Ann Oncol. 2012 Aug;23(8):2016-20. doi: 10.1093/annonc/mds103. Epub 2012 May 6.

Impact of early access to a palliative/supportive care intervention on pain management in patients with cancer.

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1
Palliative Care Unit Azienda Unitaria Sanitaria Locale (USL), Modena, Italy.

Abstract

BACKGROUND:

No study has so far addressed whether differences do exist in the management of cancer pain between patients receiving usual care by primary specialists and those receiving early palliative/supportive intervention.

PATIENTS AND METHODS:

A multicentre cross-sectional study in 32 Italian Hospitals has included 1450 patients, receiving analgesic therapy for cancer pain: 602 with access to primary specialist alone (standard care, SC) and 848 with early access to a palliative/supportive care (ePSC) team, concomitant with primary oncology care.

RESULTS:

Statistically significant differences in the analgesic drug administration according to care model have been evident: non-opioids were more frequently used in SC (9.5% versus 2%; P<0.001), while strong opioids in ePSC group (80% versus 63%; P<0.001). The number of patients with severe pain was lower in ePSC compared with SC group (31% versus 17%; P<0.001). Results of multivariate analysis have shown that ePSC integrated with primary oncologic care (relative risk 0.69; 95% confidence interval 0.48-0.99; P=0.045) was an independent factor associated with a 31% reduced risk of suffering from severe pain.

CONCLUSIONS:

An ePSC team provides the most effective standard of analgesic therapy for cancer pain. A randomized clinical trial is needed to confirm these findings.

PMID:
22565123
DOI:
10.1093/annonc/mds103
[Indexed for MEDLINE]

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