The Tri-Institutional Pain Registry - Analysis of outpatient pain management at a specialized cancer center Journal Article

Authors: Malhotra, V. T.; Glare, P.; Tan, K. S.; Wills, J.; Gulati, A.; Puttanniah, V.; Hung, J.; Cubert, K.; Inturrisi, C.
Article Title: The Tri-Institutional Pain Registry - Analysis of outpatient pain management at a specialized cancer center
Abstract: Objectives. The Outpatient Pain Clinics at Memorial Sloan Kettering Cancer Center participated in developing a pain registry to gain insight on the referral and management of cancer pain as related to demographic information, cancer history, prescription records, and interventional pain procedures stored in the institutional database. Methods. Five cohorts (subsets of one another) were defined and compared to describe demographics and differences in management and outcomes by age, race, sex, and cancer type. Clinic patients were compared with the entire institution to determine factors associated with better pain relief and reduced side effects. Results. A small percentage were referred to a pain specialist. A total of 1,043 patients completed 3,544 surveys. Compared with the institution, there were higher proportions of patients age 51 to 60 years, nonwhites, and patients with thoracic, abdominal, and head and neck cancers. Medical management controlled pain with three drug categories in 40% of visits. Short-acting opioids were the only category that statistically provided good pain relief with fewer side effects. Pain scores were improved with increasing opioid dose. Management differed by sex, age, and race; women consistently had lower doses of opioids, poorer pain control, more side effects, and were prescribed a greater variety of medications. Conclusions. A limited set of medications was required to manage most patients in the clinic, supporting the continued place of opioids and the World Health Organization analgesic ladder in managing cancer pain. Women may need a more nuanced approach for obtaining the best balance of pain relief and side effects. © 2017 American Academy of Pain Medicine.
Keywords: cancer pain; oncology; symptom; outcome; outpatient
Journal Title: Pain Medicine
Volume: 18
Issue: 12
ISSN: 1526-2375
Publisher: Oxford University Press  
Date Published: 2017-12-01
Start Page: 2474
End Page: 2484
Language: English
DOI: 10.1093/pm/pnx136
PROVIDER: scopus
PUBMED: 29016931
PMCID: PMC5968627
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
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MSK Authors
  1. Kenneth H Cubert
    8 Cubert
  2. Amitabh Gulati
    46 Gulati
  3. Kay See   Tan
    73 Tan
  4. Jonathan   Wills
    21 Wills