Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients

Abstract

Background: Pain in cancer patients is recognised as a major health problem yet few studies of both inpatient and outpatient populations have been carried out.

Objective: To assess the frequency, type, and characteristics of pain in adult cancer patients, including both inpatients and outpatients.

Design and setting: Cross-sectional study of 1,064 adult cancer patients (437 outpatients and 627 inpatients) from 44 hospitals and/or long-term-care centres in Catalonia, Spain. Cancer patients suffering from pain of any aetiology for ≥ 2 weeks and/or under analgesic treatment ≥ 2 weeks were enrolled.

Measurements: Demographic and pain data were collected. The Spanish version of the Brief Pain Inventory was used to assess pain.

Results: Pain frequency was 55.3%.Pain was less frequent in outpatients than inpatients (41.6% vs. 64.7%; p < 0.001), although median pain duration was longer in outpatients (20 vs. 6 weeks; p < 0.001). Pain was assessable in 333 patients, and intensity was similar in both out- and in-patients ; however, outpatients reported less improvement, less pain interference with daily life, and less pain related to the cancer per se. In both groups, patients with multiple myeloma (73%), breast (65%), and lung cancer (61%) were most likely to report pain.

Conclusions: Pain in cancer patients, both ambulatory and hospitalised, remains a challenge for health-care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, aproblem that is particularly notable in outpatients due to the intensity and duration of the pain.