• Support Care Cancer · Dec 2013

    Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit.

    • Sebastiano Mercadante, Costanza Guccione, Simona Di Fatta, Valentina Alaimo, Giovanna Prestia, Rosanna Bellingardo, Vittorio Gebbia, Antonino Giarratano, and Alessandra Casuccio.
    • Anesthesia & Intensive Care and Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, and Palliative Medicine, University of Palermo, Via S. Lorenzo 312, 90145, Palermo, Italy, terapiadeldolore@lamaddalenanet.it.
    • Support Care Cancer. 2013 Dec 1;21(12):3287-92.

    BackgroundThis survey was performed to draw information on pain prevalence, intensity, and management from a sample of patients who were admitted to an oncologic center where a palliative care unit (PCU) has been established for 13 years.MethodsCross-sectional survey in an oncological department performed 1 day per month for six consecutive months.ResultsOf the 385 patients, 69.1, 19.2, 8.6, and 3.1 % had no pain, mild, moderate, and severe pain, respectively. Inpatients and patients with a low Karnofsky score showed higher levels of pain intensity (p < 0.0005). One hundred twenty-eight patients with pain or receiving analgesics were analyzed for pain management index (PMI). Only a minority of patients had negative PMI score, which was statistically associated with inpatient admission (p = 0.011). Fifty of these 128 patients had breakthrough pain (BTP), and all of them were receiving some medication for BTP.ConclusionIt is likely that the presence of PCU team providing consultation, advices, and cultural pressure, other than offering admissions for difficult cases had a positive impact on the use of analgesics, as compared with previous similar surveys performed in oncological setting, where a PCU was unavailable. This information confirms the need of the presence of a PCU in a high volume oncological department.

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