Pain and quality of life of cancer patients: a multi-center study in Thailand.
OBJECTIVE
To identify the association between Quality Of Life (QOL) and pain intensity, and the magnitude of change of pain scores that have a clinically significant impact on patients' QOL.


METHODS
Multi-center; prospective cohort study.


METHODS
Patients suffering from cancer pain were recruited from seven university hospitals and three tertiary care centers in Thailand. The FACT-G and the Brief Pain Inventory were used to assess QOL and cancer pain severity, respectively, at study entry and at two-week follow-up.


RESULTS
Five-hundred-and-twenty patients were recruited with a mean age of 52. The majority (76%) reported two sites of pain with 80% being treated at either step 2 or 3 (WHO guidelines of pain management). After two weeks, the average level of maximum pain was reduced from 6.6 to 4.8 (mean difference = -1.8, p < 0.001) and the QOL was improved from 58.6 to 61.0 (mean difference = 2.4, p < 0.001). There was a high correlation between the average change of pain intensity and QOL scores (rs = -0.42, p < 0.001). The results show that changes of pain scores of at least three points (3 out of 10) were required for a minimal important difference of FACT-G scores, indicating a significant change on patients' QOL. Pain deterioration had slightly more impact on QOL than pain improvement. A 3-point pain deterioration impaired QOL 10.3 points while 3-point reduction increased QOL only 7.6 points.


CONCLUSIONS
The present findings suggest the importance of pain management. The change of pain scores of at least three points (out of 10 points) had statistical and clinical significance to patients' QOL.
Thienthong
Somboon
S
Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Thailand. somthi@kku.ac.th
Pratheepawanit
Nutjaree
N
Limwattananon
Chulaporn
C
Maoleekoonpairoj
Savitree
S
Lertsanguansinchai
Prasert
P
Chanvej
Laksamee
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life