Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl
Abstract Background Low body mass index (BMI) is suspected of being associated with low transdermal fentanyl (TDF) blood levels and worse pain relief. Clinical pain data to support this claim are lacking. Methods Using a Chronic Pain Registry, we identified 901 cancer patients who received TDF at ou...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.2479 |
| _version_ | 1811270001566416896 |
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| author | Natalie Moryl Ali Bokhari Yvona Griffo Rachel Hadler Lauren Koranteng Alexandra Filkins Tianyu Zheng Susan D. Horn Charles E. Inturrisi |
| author_facet | Natalie Moryl Ali Bokhari Yvona Griffo Rachel Hadler Lauren Koranteng Alexandra Filkins Tianyu Zheng Susan D. Horn Charles E. Inturrisi |
| author_sort | Natalie Moryl |
| collection | DOAJ |
| description | Abstract Background Low body mass index (BMI) is suspected of being associated with low transdermal fentanyl (TDF) blood levels and worse pain relief. Clinical pain data to support this claim are lacking. Methods Using a Chronic Pain Registry, we identified 901 cancer patients who received TDF at outpatient pain service clinics of our cancer center from 7/1/2011 to 12/1/2016. Of these, 240 patients had a BMI measure, pain intensity, and pain relief scores documented within 30 days of a TDF order. We examined associations between BMI, TDF dose, Worst and Least pain scores, and pain relief scores using standard statistical tests. Results In cancer patients receiving TDF, low BMI (<18.5) was significantly associated with greater pain relief irrespective of TDF dose and borderline significantly associated with greater percent pain relief after controlling for age, cancer diagnoses, and pain etiology (P = .073), suggesting that low BMI may independently predict better pain relief in cancer patients. As there were no significant associations between BMI and TDF dose, we find no basis for BMI‐dependent dose modification or avoiding TDF in cachectic and low BMI patients. Conclusions When predicting percent pain relief, we conclude that there is no basis for avoiding TDF or modifying its dose in cancer patients with low BMI and cachexia. |
| first_indexed | 2024-04-12T21:53:00Z |
| format | Article |
| id | doaj.art-72d8095de36742fa8fdf5bb056502555 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-12T21:53:00Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-72d8095de36742fa8fdf5bb0565025552022-12-22T03:15:24ZengWileyCancer Medicine2045-76342019-12-018187516752210.1002/cam4.2479Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanylNatalie Moryl0Ali Bokhari1Yvona Griffo2Rachel Hadler3Lauren Koranteng4Alexandra Filkins5Tianyu Zheng6Susan D. Horn7Charles E. Inturrisi8The Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAHealth System Innovation and Research Division University of Utah School of Medicine Salt Lake City UT USAHealth System Innovation and Research Division University of Utah School of Medicine Salt Lake City UT USAThe Palliative Medicine Memorial Sloan Kettering Cancer Center New York NY USAAbstract Background Low body mass index (BMI) is suspected of being associated with low transdermal fentanyl (TDF) blood levels and worse pain relief. Clinical pain data to support this claim are lacking. Methods Using a Chronic Pain Registry, we identified 901 cancer patients who received TDF at outpatient pain service clinics of our cancer center from 7/1/2011 to 12/1/2016. Of these, 240 patients had a BMI measure, pain intensity, and pain relief scores documented within 30 days of a TDF order. We examined associations between BMI, TDF dose, Worst and Least pain scores, and pain relief scores using standard statistical tests. Results In cancer patients receiving TDF, low BMI (<18.5) was significantly associated with greater pain relief irrespective of TDF dose and borderline significantly associated with greater percent pain relief after controlling for age, cancer diagnoses, and pain etiology (P = .073), suggesting that low BMI may independently predict better pain relief in cancer patients. As there were no significant associations between BMI and TDF dose, we find no basis for BMI‐dependent dose modification or avoiding TDF in cachectic and low BMI patients. Conclusions When predicting percent pain relief, we conclude that there is no basis for avoiding TDF or modifying its dose in cancer patients with low BMI and cachexia.https://doi.org/10.1002/cam4.2479cancer managementclinical observationsmedical oncologynutrition |
| spellingShingle | Natalie Moryl Ali Bokhari Yvona Griffo Rachel Hadler Lauren Koranteng Alexandra Filkins Tianyu Zheng Susan D. Horn Charles E. Inturrisi Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl Cancer Medicine cancer management clinical observations medical oncology nutrition |
| title | Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| title_full | Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| title_fullStr | Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| title_full_unstemmed | Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| title_short | Does transdermal fentanyl work in patients with low BMI? Patient‐reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| title_sort | does transdermal fentanyl work in patients with low bmi patient reported outcomes of pain and percent pain relief in cancer patients on transdermal fentanyl |
| topic | cancer management clinical observations medical oncology nutrition |
| url | https://doi.org/10.1002/cam4.2479 |
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