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Medline ® Abstract for Reference 4

of 'Pain assessment and management in the last weeks of life'

High prevalence of pain in patients with cancer in a large population-based study in The Netherlands.
van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J
Pain. 2007;132(3):312. Epub 2007 Oct 3.
UNLABELLED: At present, no definite conclusions can be drawn about the real extent of the pain suffered by cancer patients. A population-based study was conducted to obtain reliable information about the prevalence and severity of pain in cancer patients (all phases) and about predictors of pain. A representative sample of cancer patients was recruited in the area from a cancer registry. Pain was assessed by the Brief Pain Inventory (BPI). Adequacy of pain treatment was assessed with the Pain Management Index (PMI). We found that 55% of the 1429 respondents had experienced pain past week; in 44% (n=351), the pain was moderate to severe (BPI score>or= 4). Total prevalence of pain/moderate to severe pain was present in 49%/41% in patients with curative treatment>or=6 months ago, 57%/43% in patients with current curative treatment or treatment<6 months ago, 56%/43% in patients with current palliative anti-cancer treatment and in 75%/70% in patients for whom treatment was no longer feasible. Positive predictors of the prevalence of pain were lower education level, more advanced disease and haematological (excluding (non)-Hodgkin lymphoma), gastro-intestinal, lung, or breast malignancies. According to the PMI, analgesic treatment was inadequate in 42% of the patients. Negative predictors of adequate treatment were current curative anti-cancer treatment and low education level.
CONCLUSION: A substantial proportion of cancer patients does suffer from moderate to severe pain and does not receive adequate pain treatment.
University Hospital Maastricht, Pain Management and Research Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. mvdb@adcc.azm.nl