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Pain and pain alleviation in hospital-based home care: demographic, biological and treatment factors
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
2003 (English)In: Supportive Care in Cancer, ISSN 0941-4355, Vol. 11, no 1, 35-40 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to contrast two opposed groups, namely palliative cancer patients who were suffering significant pain (VASgreater than or equal to4) and palliative cancer patients with no pain (VAS = 0) in hospital-based home care and, retrospectively, to study possible differences in relation to demographic, biological and treatment factors. The ESAS (Edmonton Symptom Assessment Scale) was used to assess 191 palliative cancer patients on admission and after I week of home care. Fifty-two (27%) had pain (mean 5.5+/-1.7) and 72 (38%) had no pain on admission [the middle group, (n=67) had VAS 1-3]. Activity was more severely affected (5.4 vs 4.2, p<0.01) and nausea less well controlled in patients with pain (2.3 vs 0.7, P<0.0001). Pain was associated with the diagnosis of prostate cancer (P<0.01) and the presence of skeletal metastases (P<0.001), whereas pain-free patients, with or without analgesics, more often had colorectal cancer (P<.01) or melanoma (P<0.05). The medication profiles differed between the two groups: 22 (42%) of the 52 patients with pain were on step 3 of the WHO analgesic ladder and 24 of 51 (47%) were receiving antiemetics, whereas 42 (58%) of the 72 patients with no current pain had no analgesic prescribed and only 25% of them had antiemetics prescribed, indicating biological differences. If pain was present on admission a pain analysis was formally documented in 23 (44%) of the 52 cases and the medication was changed in 27 of the 52 (52%). The patients improved after I week (5.4+/-1.6 vs 3.9+/-2.3, P<0.001), and the improvement was significant even when a pain analysis was not documented or when medication was not changed. In conclusion, the results of this study indicate biological differences in pain alleviation and the need for a more structured way of working.

Place, publisher, year, edition, pages
2003. Vol. 11, no 1, 35-40 p.
Keyword [en]
pain, palliative care, ESAS, opioids, neoplasm
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-47819DOI: 10.1007/s00520-002-0398-4OAI: diva2:268715
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2009-10-14

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Strang, Peter
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Faculty of Health SciencesDepartment of Biomedicine and Surgery
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ReferencesLink to record
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