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Personalized Pain Goal Achievement with Comparable Pain Intensity and Lower Palliative Care Referral in Adolescents
Hideaki Hasuo1, Hiroko Sakuma1, Mariko Shimazu1
1Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan.
Background:
Adolescents and young adults (AYAs) with cancer usually receive high-intensity end-of-life care; however, early integration of specialized palliative care can mitigate this.
Objective:
To examine personalized pain goal (PPG) achievement and palliative care visits for pain management among AYAs with cancer.
Design:
Cross-sectional survey.
Setting/Patients:
Consecutively-enrolled outpatients and inpatients with cancer at a university hospital.
Measurements:
Patient data and self-reported questionnaires were collected from medical records.
Results:
Among 1226 patients with cancer-related pain, 56 (4.6%) were AYAs. Median pain intensity and PPGs were four each. Pain intensity did not differ significantly between AYAs and older patients (p = 0.768); however, AYAs reported higher scores as their PPGs compared to older patients (p < 0.001). AYAs had greater achievement of PPGs (>50%, p = 0.025) and fewer visits to palliative care centers (p < 0.001).
Conclusions:
Although AYAs more frequently achieved their PPGs, they also reported comparable pain intensity and had significantly lower referral rates to palliative care centers. These findings suggest that achievement of PPGs alone may not fully capture unmet pain management needs in AYAs and that proactive referral should be considered when pain intensity remains substantial.
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