Pattern of analgesic prescriptions and pain-related outcomes in older patients with cancer: A retrospective observational study
Notice bibliographique
Résumé
Background: Adequate pain management in patients with cancer is crucial, as uncontrolled pain affects their physical and psychological well-being, and impacts sleep, activities of daily living (ADL), and quality of life. Objectives: This study aimed to evaluate the prevalence of untreated pain, pattern of analgesic use, and physical and psychological deficits related to pain in older patients with cancer who had moderate or severe pain. Materials and Methods: This was a retrospective observational study conducted between February 2022 and April 2023 in the geriatric oncology clinic of the Department of Medical Oncology at the Tata Memorial Hospital in Mumbai, India. Pain intensity, type of analgesics consumed, anxiety (measured by the Generalized Anxiety Disorder Questionnaire-7), depression (measured by the Geriatric Depression Scale: Short Form), sleep disturbance (Yes/No question), and functional deficits (measured by the Katz Index of Independence in Activities of Daily Living, Lawton Instrumental activities of Daily Living Scale, and Timed Up and Go Test) were captured from the dataset. Pain intensity was assessed using the Edmonton Symptom Assessment System (ESAS), in which “0” indicated “no pain” and “10” indicated the “worst possible pain.” A pain intensity score of 4 or more was considered significant; scores from 4-7 were categorized as moderate pain, and 8-10 as severe pain. Results: We evaluated 1203 patients in the geriatric oncology clinic and enrolled 321 (26.7%) who had reported pain intensity of 4 or higher 260 (21.6%) had moderate pain, and 61 (5.1%) had severe pain. The mean pain score was 5.8 (standard deviation, 1.6). Higher pain scores were associated with higher prevalence of anxiety, depression, sleep disturbance, and functional deficits. There were 158 (49.2%) patients who had not been prescribed any pain medication. Analgesics prescribed for the 260 patients with moderate pain included opioids ( n =14; 5.4%), non-opioids ( n =35; 13.5%), combined opioids and non-opioids ( n =71; 27.3%), and no treatment ( n =140; 53.8%). Analgesics prescribed for the 61 patients with severe pain included opioids ( n =4; 6.6%), non-opioids ( n =16; 26.2%), combined opioids and non-opioids ( n =23; 37.7%), and no treatment ( n =18; 29.5%). Overall, tramadol ( n =76; 67.9%) and non-steroidal anti-inflammatory drugs ( n =93; 64.1%) were the most frequently used analgesics. Conclusion: Pain affects the mental and physical wellbeing of older patients with cancer. Over half of the older Indian patients with cancer who have moderate pain and about a third with severe pain are not on any analgesics. This is an urgent unmet need, and assessment of pain must become part of the routine evaluation of all patients. (Clinical Trials Registry-India: CTRI/2020/04/024675).
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».