Highlights
- •A registry with patient characteristics, treatments, and outcomes of cancer patients.
- •Average pain intensity was mild for 24.6%, moderate for 41.5%, and severe for 33.9%.
- •Median daily opioid dose in morphine equivalents was 109 (range = .4 to 3,960).
- •Men are twice as likely as women to have an opioid ordered at a higher dosage.
- •Opioid use and dosage are essential to understand patient reported outcomes.
Abstract
The Memorial Sloan Kettering Pain Registry contains patient characteristics, treatments,
and outcomes for a prospective cohort of 1,534 chronic pain cancer patients who were
seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory)
was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%.
The patient's report of average percent pain relief and health state (EuroQOL 5 dimensions)
was inversely related to average pain intensity category, whereas measures of pain
interference, number of worst pain locations, and physical and psychological distress
were directly related to pain intensity category. Eighty-six percent of patients received
an opioid at 1 or more clinic encounters. Regression analysis revealed that male sex
or being younger (65 years of age or younger) was associated with a greater likelihood
of an opioid ordered. Male sex nearly doubled the likelihood of a higher dose being
ordered than female sex. Bivariate analysis found that patients receiving opioids
reported significantly more pain relief than no-opioid patients. However, patients
receiving opioids had higher pain interference scores, lower index of health state,
and more physical distress than no-opioid patients Our results identify the need to
consider opioid use and dosage when attempting to understand patient-reported outcomes
(PROs) and factors affecting pain management.
Perspective
This report describes the results of the analyses of PROs and patient-related electronic
health record data collected under standard of care from cancer patients at outpatient
pain management clinics of Anesthesiology and Palliative Care at the Memorial Sloan
Kettering Cancer Center. Consideration of sex and age as predictors of opioid use
is critical in attempting to understand PROs and their relationship to pain management.
Key words
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Article info
Publication history
Published online: November 14, 2017
Accepted:
November 3,
2017
Received in revised form:
October 23,
2017
Received:
August 27,
2017
Footnotes
N.M. and V.D. contributed equally to this work.
The Registry was developed with the support of grant RC2 DA028928 from the National Institute on Drug Abuse and was supported in part by a grant from Purdue Pharm, Ltd, the MSK Cancer Center Support Grant/Core Grant (P30 CA008748), and the Weill Cornell Medical College Bridge Fund. None of the supporters read or had any editorial influence on the report.
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2017 by the American Pain Society
