title: Investigating the effects of TTS-fentanyl for cancer pain on the psychological status of patients naïve to strong opioids: an open label study.
abstract: Few studies have investigated the effect of fentanyl delivered via the transdermal route with regard to the patient's psychological status. Patients who were naive to strong opioids and were attending a palliative care unit for pain relief from advanced cancer participated in this study to determine the effect of transdermal therapeutic system fentanyl (TTS-F) on their psychological condition. Spielberger State-Trait Anxiety Inventory (STAI), Zung Self-Rating Depression Scale (SDS), the Karnofsky Performance Scale (100-0, optimum-death), and a Visual Analogue Scale (VAS) (0: no pain; 10: worst pain) were used to measure the level of pain. Data were collected at baseline (T0), on the 7th day (T1), and on the 14th day (T2) of TTS-F application in order to determine changes in correlation to TTS-F dose. Patients' status improved according to the Zung SDS questionnaire (P < .0005) and with each of its subscales (P < .05). A similar improvement was observed according to the Spielberger STAI questionnaire (P = .002). Moreover, VAS measures demonstrated that patients achieved significant pain relief (P < .0005), while patients' performance status did not alter significantly over the study period. Furthermore, the Zung SDS showed a statistically significant correlation when compared with the Spielberger STAI (P < .01). These data provide some evidence that the psychological status, as measured with respect to depression and anxiety in patients with advanced cancer, is improved in patients receiving TTS-fentanyl. Future research should use a broad range of psychological measurements in order to assist the development of practices, which are aimed at the improvement of quality of life in these patients.
authors.affiliation: Department of Radiology, the Pain Relief and Palliative Care Unit, Areteion Hospital, School of Medicine, University of Athens, Athens, Hellas. mistakidou@yahoo.com
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.forename: Eleni
authors.initials: E
authors.lastname: Tsilika
authors.forename: Efi
authors.initials: E
authors.lastname: Parpa
authors.forename: Charalambos
authors.initials: C
authors.lastname: Papageorgiou
authors.forename: Stavroula
authors.initials: S
authors.lastname: Georgaki
authors.forename: Lambros
authors.initials: L
authors.lastname: Vlahos
mesh_terms: D000203:Activities of Daily Living; D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001294:Attitude to Health; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods / Q000523:psychology / Q000592:standards; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl