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The Effectiveness of Cancer Pain Management in a Tertiary Hospital Outpatient Pain Clinic in Thailand: A Prospective
Suratsawadee Wangnamthip1,2, Skaorat Panchoowong1, Carolina Donado2,3
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Insights
The updated Siriraj multidisciplinary approach effectively managed cancer pain, with 61% of patients showing significant improvement. Radiation therapy during treatment predicted positive pain outcomes, highlighting its role in patient care.
Area of Science:
- Oncology
- Pain Management
- Clinical Research
Background:
- Cancer pain significantly impacts patient quality of life.
- Multidisciplinary approaches are crucial for effective cancer pain management.
- Evaluating updated treatment protocols is essential for optimizing patient outcomes.
Purpose of the Study:
- To assess the effectiveness of an updated multidisciplinary approach for cancer pain.
- To identify predictors of favorable pain response in cancer patients.
- To analyze trends in pain scores, symptom burden, and analgesic use.
Main Methods:
- A prospective study enrolled 150 cancer outpatients from January to December 2018.
- Data collected at baseline and three follow-up visits included Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), and Edmonton Symptom Assessment System (ESAS).
- Logistic regression analyzed predictors of pain response, with a favorable response defined as NRS decrease >30% or NRS <4.
Main Results:
- 61% of the 72 completers (48% of total enrollment) achieved a favorable pain response at FU3.
- Pain interference significantly decreased (p < 0.05), while median morphine equivalent daily dosage (MEDD) showed a modest increase.
- Radiation therapy during pain care emerged as a predictor of pain response.
Conclusions:
- The Siriraj multidisciplinary approach effectively relieved cancer pain and stabilized related symptoms.
- Radiation therapy can predict pain outcomes in cancer patients.
- Further improvements should consider cultural, economic, and geographic factors for comprehensive care.
Objectives:
The objective was to examine the effectiveness of the updated approach.
Methods:
With IRB approval, outpatients with cancer were enrolled from January to December 2018. Assessments were recorded at baseline and three consecutive visits (BL, FU1, FU2, and FU3), including Numerical Rating Scale (NRS), the Brief Pain Inventory (BPI), the Edmonton Symptom Assessment System (ESAS), side effects, and analgesic use. The primary outcome was a favorable response, defined as an NRS decrease more than 30% or NRS <4. Secondary outcomes included trends over time in BPI, ESAS, side effects, and analgesic use. Pain response predictors at FU3 were analyzed using logistic regression.
Results:
Among 150 patients, 72 (48%) completed follow-ups. Of these, 61% achieved a favorable response at FU3. Pain interference diminished at all visits relative to baseline (p < 0.05). Median morphine equivalent daily dosage (MEDD) at BL was 20 mg/day, with a statistically significant, but clinically modest increase to 26.4 mg/day at FU3. Radiation therapy during pain care was a predictor of pain responders.
Conclusion:
The current Siriraj multidisciplinary approach provided effective relief of pain and stabilization of other cancer-related symptoms. Radiation therapy during pain care can be used to predict pain outcomes. Ongoing improvement domains were identified and considered in the context of cultural, economic, and geographic factors.
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