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Improvement of pain management in a comprehensive cancer center: a comparison of two cross-sectional studies 8 years apart

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Abstract

Context

In 2011, a multidisciplinary palliative team (MPT) was established at Rigshospitalet (DK) and a cross-sectional study in inpatients was carried out at the Departments of Oncology and Hematology. High symptom burden, high prevalence of pain (64%), and insufficient analgesic treatment were demonstrated. In 2019, a similar study was carried out.

Objectives

This study compares prevalence of symptoms including pain and analyzes analgesic treatment of adult in-patients in a comprehensive cancer center.

Methods

Two cross-sectional studies (May–Jun 2011; Feb–Sep 2019). Inclusion criteria: malignant diseases, age ≥ 18 y, able to understand Danish. EORTC QLQ-C30 and Brief Pain Inventory (BPI) were applied.

Results

A total of 134 and 183 inpatients were included in 2011 and 2019, respectively. Differences in the two populations were seen; in 2019 more patients had advanced disease (P = 0.0096), lower performance status (P = 0.0028), and a palliative treatment plan (P = 0.0034). The prevalence of impairments and symptoms was high and similar in the 2 years with exception of severe pain (P = 0.0143) and neuropathic pain (P < 0.0001) which increased in 2019. Moreover, pain relief significantly improved, and significantly fewer patients with pain were left untreated. Significant increase in opioid and adjuvant analgesic prescription in 2019.

Conclusion

An overall unchanged high symptom burden was observed. However, improvement of pain management was observed in 2019. The establishment of a MPT may possibly have contributed to improved pain management.

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Data Availability

Data is available upon request and can be given within the approval from the Danish Data Protection Agency (VD-2019–68).

Code availability

N/A.

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Funding

This study was supported by a Grant from Oncological Research Foundation, Rigshospitalet, total 5000 DKK, for statistical analysis.

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Authors and Affiliations

  1. Section of Palliative Medicine, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark

    Jonas Sørensen, Tanja Vibeke Sørensen & Katja Heinecke

  2. Palliative Research Group, Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark

    Per Sjøgren & Geana Paula Kurita

  3. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Per Sjøgren & Geana Paula Kurita

  4. Department of Hematology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark

    Stine Novrup Clemmensen

  5. Multidisciplinary Pain Centre, Department of Neuroanaesthesiology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark

    Geana Paula Kurita

Authors
  1. Jonas Sørensen
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  2. Per Sjøgren
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  3. Stine Novrup Clemmensen
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  4. Tanja Vibeke Sørensen
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  5. Katja Heinecke
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  6. Geana Paula Kurita
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Contributions

Jonas Sørensen, Per Sjøgren and Geana Paula Kurita were involved in the conception and design of the study. Jonas Sørensen, Per Sjøgren and Geana Paula Kurita made the analysis plan. Jonas Sørensen, Stine Novrup Clemmensen, Tanja Vibeke Sørensen, and Katja Heinecke collected data. Jonas Sørensen and Geana Paula Kurita made the data analysis. Jonas Sørensen, Per Sjøgren, Stine Novrup Clemmensen, Tanja Vibeke Sørensen, Katja Heinecke and Geana Paula Kurita were involved in the interpretation of the data. Jonas Sørensen, Per Sjøgren and Geana Paula Kurita made the draft manuscript, which was revised and approved by all co-authors.

Corresponding author

Correspondence to Jonas Sørensen.

Ethics declarations

Ethics approval and consent to participate

Collecting data from consenting inpatients was approved by the Danish Data Protection Agency (VD-2019–68). Non-interventional studies do not require approval from Ethic Committee in Denmark. All patients received oral and written information, and informed consent was obtained from all patients prior to inclusion.

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Conflict of interest

The authors declare no competing interests.

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Key message

This study provides information on development of symptoms and treatment of adult cancer inpatients eight years after the establishment of a specialized palliative care (SPC) service in a comprehensive cancer center. The prevalence of symptoms during the period remained high; however, significant improvement on pain management and relief was found.

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Sørensen, J., Sjøgren, P., Clemmensen, S.N. et al. Improvement of pain management in a comprehensive cancer center: a comparison of two cross-sectional studies 8 years apart. Support Care Cancer 30, 2037–2045 (2022). https://doi.org/10.1007/s00520-021-06614-x

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  • DOI: https://doi.org/10.1007/s00520-021-06614-x

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