Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study
Background: Pain is a prevalent symptom among cancer patients, and its management is crucial for improving their quality of life. However, pain management in cancer patients referred to radiotherapy (RT) departments is often inadequate, and limited research has been conducted on this specific popula...
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MDPI AG
2023-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/1/109 |
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| author | Costanza M. Donati Chiara Maria Maggiore Marco Maltoni Romina Rossi Elena Nardi Alice Zamagni Giambattista Siepe Filippo Mammini Francesco Cellini Alessia Di Rito Maurizio Portaluri Cristina De Tommaso Anna Santacaterina Consuelo Tamburella Rossella Di Franco Salvatore Parisi Sabrina Cossa Vincenzo Fusco Antonella Bianculli Pierpaolo Ziccarelli Luigi Ziccarelli Domenico Genovesi Luciana Caravatta Francesco Deodato Gabriella Macchia Francesco Fiorica Giuseppe Napoli Milly Buwenge Alessio G. Morganti |
| author_facet | Costanza M. Donati Chiara Maria Maggiore Marco Maltoni Romina Rossi Elena Nardi Alice Zamagni Giambattista Siepe Filippo Mammini Francesco Cellini Alessia Di Rito Maurizio Portaluri Cristina De Tommaso Anna Santacaterina Consuelo Tamburella Rossella Di Franco Salvatore Parisi Sabrina Cossa Vincenzo Fusco Antonella Bianculli Pierpaolo Ziccarelli Luigi Ziccarelli Domenico Genovesi Luciana Caravatta Francesco Deodato Gabriella Macchia Francesco Fiorica Giuseppe Napoli Milly Buwenge Alessio G. Morganti |
| author_sort | Costanza M. Donati |
| collection | DOAJ |
| description | Background: Pain is a prevalent symptom among cancer patients, and its management is crucial for improving their quality of life. However, pain management in cancer patients referred to radiotherapy (RT) departments is often inadequate, and limited research has been conducted on this specific population. This study aimed to assess the adequacy and effectiveness of pain management when patients are referred for RT. Moreover, we explored potential predictors of adequate pain management. Methods: This observational, prospective, multicenter cohort study included cancer patients aged 18 years or older who were referred to RT departments. A pain management assessment was conducted using the Pain Management Index (PMI), calculated by subtracting the pain score from the analgesic score (PMI < 0 indicated inadequate pain management). Univariate and multivariate analyses were performed to identify predictors of adequate pain management. Results: A total of 1042 cancer outpatients were included in the study. The analysis revealed that 42.9% of patients with pain did not receive adequate pain management based on PMI values. Among patients with pain or taking analgesics and referred to palliative or curative RT, 72% and 75% had inadequate or ineffective analgesic therapy, respectively. The odds of receiving adequate pain management (PMI ≥ 0) were higher in patients undergoing palliative RT (OR 2.52; <i>p</i> < 0.001), with worse ECOG-PS scores of 2, 3 and 4 (OR 1.63, 2.23, 5.31, respectively; <i>p</i>: 0.017, 0.002, 0.009, respectively) compared to a score of 1 for those with cancer-related pain (OR 0.38; <i>p</i> < 0.001), and treated in northern Italy compared to central and southern of Italy (OR 0.25, 0.42, respectively; <i>p</i> < 0.001). Conclusions: In this study, a substantial proportion of cancer patients referred to RT departments did not receive adequate pain management. Educational and organizational strategies are necessary to address the inadequate pain management observed in this population. Moreover, increasing the attention paid to non-cancer pain and an earlier referral of patients for palliative RT in the course of the disease may improve pain response and treatment outcomes. |
| first_indexed | 2024-03-08T15:10:55Z |
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| id | doaj.art-fb4d335736c7472089590e9a7720c23a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T15:10:55Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-fb4d335736c7472089590e9a7720c23a2024-01-10T14:52:41ZengMDPI AGCancers2072-66942023-12-0116110910.3390/cancers16010109Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 StudyCostanza M. Donati0Chiara Maria Maggiore1Marco Maltoni2Romina Rossi3Elena Nardi4Alice Zamagni5Giambattista Siepe6Filippo Mammini7Francesco Cellini8Alessia Di Rito9Maurizio Portaluri10Cristina De Tommaso11Anna Santacaterina12Consuelo Tamburella13Rossella Di Franco14Salvatore Parisi15Sabrina Cossa16Vincenzo Fusco17Antonella Bianculli18Pierpaolo Ziccarelli19Luigi Ziccarelli20Domenico Genovesi21Luciana Caravatta22Francesco Deodato23Gabriella Macchia24Francesco Fiorica25Giuseppe Napoli26Milly Buwenge27Alessio G. Morganti28Radiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyCardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyRadiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyRadiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, IRCCS, UOC di Radioterapia, Fondazione Policlinico Universitario A. Gemelli, 00168 Roma, ItalyIRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, ItalyGeneral Hospital “Perrino”, 72100 Brindisi, ItalyGeneral Hospital “Perrino”, 72100 Brindisi, ItalyU.O. di Radioterapia AOOR PAPARDO PIEMONTE, 98121 Messina, ItalyU.O. di Radioterapia AOOR PAPARDO PIEMONTE, 98121 Messina, ItalyS.C. di Radioterapia dell’Istituto Nazionale Tumori Pascale, 80131 Napoli, ItalyRadioterapia Opera di S. Pio da Pietralcina, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, ItalyRadioterapia Opera di S. Pio da Pietralcina, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, ItalyIRCCS CROB, 85028 Rionero in Vulture, ItalyIRCCS CROB, 85028 Rionero in Vulture, ItalyU.O. Radioterapia Oncologica, S.O. Mariano Santo, 87100 Cosenza, ItalyU.O. Radioterapia Oncologica, S.O. Mariano Santo, 87100 Cosenza, ItalyRadiation Oncology Unit, Università degli Studi G. D’Annunzio, 66100 Chieti, ItalyRadiation Oncology Unit, Università degli Studi G. D’Annunzio, 66100 Chieti, ItalyIstituto di Radiologia, Università Cattolica del Sacro Cuore, 00168 Roma, ItalyRadiotherapy Unit, Gemelli Molise Hospital, Catholic University of Sacred Heart, 86100 Campobasso, ItalyU.O.C. di Radioterapia e Medicina Nucleare, Ospedale Mater Salutis di Legnago, 37045 Verona, ItalyU.O.C. di Radioterapia e Medicina Nucleare, Ospedale Mater Salutis di Legnago, 37045 Verona, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyRadiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyBackground: Pain is a prevalent symptom among cancer patients, and its management is crucial for improving their quality of life. However, pain management in cancer patients referred to radiotherapy (RT) departments is often inadequate, and limited research has been conducted on this specific population. This study aimed to assess the adequacy and effectiveness of pain management when patients are referred for RT. Moreover, we explored potential predictors of adequate pain management. Methods: This observational, prospective, multicenter cohort study included cancer patients aged 18 years or older who were referred to RT departments. A pain management assessment was conducted using the Pain Management Index (PMI), calculated by subtracting the pain score from the analgesic score (PMI < 0 indicated inadequate pain management). Univariate and multivariate analyses were performed to identify predictors of adequate pain management. Results: A total of 1042 cancer outpatients were included in the study. The analysis revealed that 42.9% of patients with pain did not receive adequate pain management based on PMI values. Among patients with pain or taking analgesics and referred to palliative or curative RT, 72% and 75% had inadequate or ineffective analgesic therapy, respectively. The odds of receiving adequate pain management (PMI ≥ 0) were higher in patients undergoing palliative RT (OR 2.52; <i>p</i> < 0.001), with worse ECOG-PS scores of 2, 3 and 4 (OR 1.63, 2.23, 5.31, respectively; <i>p</i>: 0.017, 0.002, 0.009, respectively) compared to a score of 1 for those with cancer-related pain (OR 0.38; <i>p</i> < 0.001), and treated in northern Italy compared to central and southern of Italy (OR 0.25, 0.42, respectively; <i>p</i> < 0.001). Conclusions: In this study, a substantial proportion of cancer patients referred to RT departments did not receive adequate pain management. Educational and organizational strategies are necessary to address the inadequate pain management observed in this population. Moreover, increasing the attention paid to non-cancer pain and an earlier referral of patients for palliative RT in the course of the disease may improve pain response and treatment outcomes.https://www.mdpi.com/2072-6694/16/1/109pain managementcancer patientsradiotherapypain management indexmodified pain management indexpalliative care |
| spellingShingle | Costanza M. Donati Chiara Maria Maggiore Marco Maltoni Romina Rossi Elena Nardi Alice Zamagni Giambattista Siepe Filippo Mammini Francesco Cellini Alessia Di Rito Maurizio Portaluri Cristina De Tommaso Anna Santacaterina Consuelo Tamburella Rossella Di Franco Salvatore Parisi Sabrina Cossa Vincenzo Fusco Antonella Bianculli Pierpaolo Ziccarelli Luigi Ziccarelli Domenico Genovesi Luciana Caravatta Francesco Deodato Gabriella Macchia Francesco Fiorica Giuseppe Napoli Milly Buwenge Alessio G. Morganti Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study Cancers pain management cancer patients radiotherapy pain management index modified pain management index palliative care |
| title | Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study |
| title_full | Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study |
| title_fullStr | Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study |
| title_full_unstemmed | Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study |
| title_short | Adequacy of Pain Management in Patients Referred for Radiation Therapy: A Subanalysis of the Multicenter ARISE-1 Study |
| title_sort | adequacy of pain management in patients referred for radiation therapy a subanalysis of the multicenter arise 1 study |
| topic | pain management cancer patients radiotherapy pain management index modified pain management index palliative care |
| url | https://www.mdpi.com/2072-6694/16/1/109 |
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