Patient-reported outcomes and opioid use by outpatient cancer patients Journal Article

Authors: Moryl, N.; Dave, V.; Glare, P.; Bokhari, A.; Malhotra, V. T.; Gulati, A.; Hung, J.; Puttanniah, V.; Griffo, Y.; Tickoo, R.; Wiesenthal, A.; Horn, S. D.; Inturrisi, C. E.
Article Title: Patient-reported outcomes and opioid use by outpatient cancer patients
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. © 2017 The American Pain Society
Keywords: adult; controlled study; aged; middle aged; major clinical study; constipation; cancer patient; opiate; palliative therapy; cancer pain; age; dyspnea; health care quality; health status; distress syndrome; outpatient; patient-reported outcomes; analgesia; drug use; sex; comparative effectiveness; patient-reported outcome; pain intensity; human; male; female; article; chronic cancer pain; electronic health record; pain severity; opioid analgesic use; opioid dosage
Journal Title: Journal of Pain
Volume: 19
Issue: 3
ISSN: 1526-5900
Publisher: Churchill Livingstone  
Date Published: 2018-03-01
Start Page: 278
End Page: 290
Language: English
DOI: 10.1016/j.jpain.2017.11.001
PROVIDER: scopus
PMCID: PMC5811357
PUBMED: 29154919
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
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MSK Authors
  1. Amitabh Gulati
    44 Gulati
  2. Natalia Moryl
    35 Moryl
  3. Roma Tickoo
    14 Tickoo
  4. Yvona Griffo
    6 Griffo
  5. Paul A Glare
    46 Glare
  6. Joseph C Hung
    11 Hung
  7. Vinnidhy Hemang Dave
    5 Dave