Adjuvant Analgesic Use for Cancer-Related Pain in Ambulatory Oncology Care
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Jessica B Emshoff1, Ellyse Kostensky2, Ashley Conger1
1Northeast Ohio Medical University College of Pharmacy, University Hospitals Portage Medical Center, Rootstown, Ohio, USA.
Abstract:
Supportive oncology improves quality of life and symptom control for patients with cancer. This retrospective cohort analysis compared adjuvant analgesic therapies across three ambulatory settings at a Midwest health system: the standard care models, including physician-led primary oncology and advanced practice provider-led supportive oncology (APP-SO), vs. an interprofessional collaborative practice supportive oncology (IPCP-SO) model with an integrated palliative care clinical pharmacist. The primary objective was to compare the median number of therapeutic adjuvants; secondary objectives were pain control and oral morphine equivalents (OME). Patients were 18 years or older with stage 3 or 4 cancer, cancer-related pain, and cancer-directed treatment. Random sampling yielded 75 patients per group (N = 225) from 2019-2025 records. Groups had comparable baseline characteristics (p > .05). IPCP-SO was associated with more adjuvants than physician-led primary oncology (incidence rate ratio [IRR] 8.17, 95% CI: 5.19-12.87, p < .001) and APP-SO (IRR 2.02, 95% CI: 1.52-2.69, p < .001). Median clinic-visit numeric rating scale reduction was 1 point in the standard-model cohorts and 3 points in IPCP-SO. Median last-visit OME was lowest in physician-led primary oncology. IPCP-SO was associated with greater adjuvant use and greater pain reduction than APP-SO and physician-led primary oncology.
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