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Characterizing Relationships Between Daily Pain, Opioid Use, and Mood in Patients With Advanced Cancer Using

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Daily fluctuations in pain catastrophizing worsen pain severity in advanced cancer patients. Tracking this variability may help personalize pain management and identify high-risk days for better support.

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Area of Science:

  • Oncology
  • Pain Management
  • Psychosocial Oncology

Background:

  • Pain, opioid use, and emotional states fluctuate daily in advanced cancer.
  • These daily fluctuations may interact and influence each other.
  • Understanding within-person dynamics is crucial for effective pain management.

Purpose of the Study:

  • To quantify daily associations between pain, opioid use, and mood in advanced cancer patients.
  • To examine how pain interference and perceived opioid efficacy relate to daily pain levels.
  • To test if variability in pain catastrophizing moderates these daily associations.

Main Methods:

  • 28-day ecological momentary assessments (EMAs) were used in 26 advanced cancer patients.
  • Daily measures included pain severity, pain interference, opioid use, perceived efficacy, affect, and catastrophizing.
  • Multilevel models analyzed same-day associations, with catastrophizing variability as a moderator.

Main Results:

  • Higher pain was linked to worse interference, increased opioid use, lower perceived efficacy, and higher negative affect.
  • Greater day-to-day variability in pain catastrophizing correlated with worse pain.
  • Increased catastrophizing variability amplified the link between pain severity and interference, affect, and perceived opioid efficacy.

Conclusions:

  • Day-to-day variability in pain catastrophizing magnifies the impact of pain severity on interference, mood, and opioid efficacy.
  • Monitoring pain severity and catastrophizing variability can identify high-risk periods.
  • This approach can inform personalized pain management strategies and in-the-moment support.