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Assessment of cancer pain in outpatients undergoing radiation therapy
M-XPHINE~GES INTMANATOFCANCERPAIN S.A. Schug ;:, D.Zech , S. Grand (SOON: V.S. Hatangdi) Pain Clinic2, UniversityHospital of Cologne, Cologne, FK & Pain Clinic , Auckland Hospital,Auckland, Mew Zealand.
Exhibit Hall
AIM OF lNVESTIGATIcN: This study evaluated the mount and change of morphine dosages in a large collective of cancer pain patients (1070, 531 females, 539 males: 13 - 90 years, mean 59) under treatment following&HO guidelines. METINODS: Using standard pat&t a&essnent forms and a canplteriseddata bank system, these patients ware followed up over a period of 55,285 treatment days. AsKng others collected data included: pre-treatment, current WHO step of therapy, mode of cpioid application,dosages of analgesics,co-medication,side effects and pain assessment. REXJLTS: 638 of the surveyed patients were treated with oral (481) and parenteral (157) morphine on 22,525 days. Morphine sustained release tablets were used in 7,108 of these days. The average morphine dosage was 82.4 mg/day (range 5-1,900 n-g)for the oral and 70.9 mg/day (range 8-600 q) for tk parer&era1 mte. Under oral medication an average initial morphine dose of 61.4 mg had to be increased over the ccurse of therapy to an average last mxphine dosage of 103.9 mg. 42.2% of the patients stayed cn their initial dose for the whole tims of therapy,while 46.4% required a dose increase and 11.4% a dose decrease. cONcLusIcW: The average morphine dosages in this investigationwas found to be lawer than in others, eventually because rrprphinewas consequently ccnbined with peripherally acting analgesics and co-analgesicsfollowing WO guidelines. The finding of aore than half of the patients not requiring an increase of dosage in the course of their therapy shcws again, that long term n-txphineintake and developmentof toleranceare not necessarily linked: even the dose increase in the remaining patients is more likely to he explained by progress of the disease.
ASSESSMENT OF CANCER PAIN IN OUTPATIENTS UNDERGOING RADIATION Poster 164 RED Th-Fri THERAPY. G.A. Yanes, E.A.M.T. Obbens, J.M. Kittelson and L.G. Douglass. Departments of Radiation Oncology and Neurology, Exhibit Hall University of Arizona College of Medicine, Tucson AZ, USA. Abs No 704 AIM OF INVESTIGATION: We have developed a survey to evaluate pain in adults undergoing therapy for cancer. Our objec- 1 tives are twofold: 1) to score the severity of pain for each patient, and 2) to generate information on patients receiving specific therapies. METHODS: The survey was administered to 26 outpatients undergoing radiation therapy. Visual analog scales were used to assess severity of pain along with yes/no questions. Patients were asked about sleep, mood, and effect of pain on their ability to enjoy life or carry out certain activities. Current and previous pain treatments were recorded, as were demographic data. Based on answers to six specific questions, patients were divided into a Severe Pain (SP) and a Mild Pain (MP) cohort. RESULTS: Pain interfered significantly with activity in 18 patients; with sleep in 19 patients: and with the ability to enjoy life in 16 patients. 13 patients fit the criteria for the SP group, and 13 were assigned to the MP cohort. On a scale from O-10, 8 of the 13 SP patients scored their "worst" pain >8, while of the 13 MP patients only two did so (P=.O16). In 7 of the SP patients pain was at its worst >50% of the time, while this was the case in only 2 of the MP patients (P=.O39). Use of non-opioid, weak opioid and adjuvant therapy did not vary between groups. In each group, only one patient intervenwas receiving a strong opioid agonist. Numerous non-pharmacological tions were cited by patients in each group as effective in aiding pain relief CONCLUSION: Patients appear to be medicated uniformly regardless of the severity of their pain or the lack of pain relief. Identifying and following patients with severe pain in a systematic fashion with a standardized questionnaire should result in better long-term pain control.
Exhibit Hall
AIM OF lNVESTIGATIcN: This study evaluated the mount and change of morphine dosages in a large collective of cancer pain patients (1070, 531 females, 539 males: 13 - 90 years, mean 59) under treatment following&HO guidelines. METINODS: Using standard pat&t a&essnent forms and a canplteriseddata bank system, these patients ware followed up over a period of 55,285 treatment days. AsKng others collected data included: pre-treatment, current WHO step of therapy, mode of cpioid application,dosages of analgesics,co-medication,side effects and pain assessment. REXJLTS: 638 of the surveyed patients were treated with oral (481) and parenteral (157) morphine on 22,525 days. Morphine sustained release tablets were used in 7,108 of these days. The average morphine dosage was 82.4 mg/day (range 5-1,900 n-g)for the oral and 70.9 mg/day (range 8-600 q) for tk parer&era1 mte. Under oral medication an average initial morphine dose of 61.4 mg had to be increased over the ccurse of therapy to an average last mxphine dosage of 103.9 mg. 42.2% of the patients stayed cn their initial dose for the whole tims of therapy,while 46.4% required a dose increase and 11.4% a dose decrease. cONcLusIcW: The average morphine dosages in this investigationwas found to be lawer than in others, eventually because rrprphinewas consequently ccnbined with peripherally acting analgesics and co-analgesicsfollowing WO guidelines. The finding of aore than half of the patients not requiring an increase of dosage in the course of their therapy shcws again, that long term n-txphineintake and developmentof toleranceare not necessarily linked: even the dose increase in the remaining patients is more likely to he explained by progress of the disease.
ASSESSMENT OF CANCER PAIN IN OUTPATIENTS UNDERGOING RADIATION Poster 164 RED Th-Fri THERAPY. G.A. Yanes, E.A.M.T. Obbens, J.M. Kittelson and L.G. Douglass. Departments of Radiation Oncology and Neurology, Exhibit Hall University of Arizona College of Medicine, Tucson AZ, USA. Abs No 704 AIM OF INVESTIGATION: We have developed a survey to evaluate pain in adults undergoing therapy for cancer. Our objec- 1 tives are twofold: 1) to score the severity of pain for each patient, and 2) to generate information on patients receiving specific therapies. METHODS: The survey was administered to 26 outpatients undergoing radiation therapy. Visual analog scales were used to assess severity of pain along with yes/no questions. Patients were asked about sleep, mood, and effect of pain on their ability to enjoy life or carry out certain activities. Current and previous pain treatments were recorded, as were demographic data. Based on answers to six specific questions, patients were divided into a Severe Pain (SP) and a Mild Pain (MP) cohort. RESULTS: Pain interfered significantly with activity in 18 patients; with sleep in 19 patients: and with the ability to enjoy life in 16 patients. 13 patients fit the criteria for the SP group, and 13 were assigned to the MP cohort. On a scale from O-10, 8 of the 13 SP patients scored their "worst" pain >8, while of the 13 MP patients only two did so (P=.O16). In 7 of the SP patients pain was at its worst >50% of the time, while this was the case in only 2 of the MP patients (P=.O39). Use of non-opioid, weak opioid and adjuvant therapy did not vary between groups. In each group, only one patient intervenwas receiving a strong opioid agonist. Numerous non-pharmacological tions were cited by patients in each group as effective in aiding pain relief CONCLUSION: Patients appear to be medicated uniformly regardless of the severity of their pain or the lack of pain relief. Identifying and following patients with severe pain in a systematic fashion with a standardized questionnaire should result in better long-term pain control.