title: Impact of early access to a palliative/supportive care intervention on pain management in patients with cancer.
abstract: BACKGROUND
  No study has so far addressed whether differences do exist in the management of cancer pain between patients receiving usual care by primary specialists and those receiving early palliative/supportive intervention.
  
  
  METHODS
  A multicentre cross-sectional study in 32 Italian Hospitals has included 1450 patients, receiving analgesic therapy for cancer pain: 602 with access to primary specialist alone (standard care, SC) and 848 with early access to a palliative/supportive care (ePSC) team, concomitant with primary oncology care.
  
  
  RESULTS
  Statistically significant differences in the analgesic drug administration according to care model have been evident: non-opioids were more frequently used in SC (9.5% versus 2%; P<0.001), while strong opioids in ePSC group (80% versus 63%; P<0.001). The number of patients with severe pain was lower in ePSC compared with SC group (31% versus 17%; P<0.001). Results of multivariate analysis have shown that ePSC integrated with primary oncologic care (relative risk 0.69; 95% confidence interval 0.48-0.99; P=0.045) was an independent factor associated with a 31% reduced risk of suffering from severe pain.
  
  
  CONCLUSIONS
  An ePSC team provides the most effective standard of analgesic therapy for cancer pain. A randomized clinical trial is needed to confirm these findings.
authors.affiliation: Palliative Care Unit Azienda Unitaria Sanitaria Locale (USL), Modena.
authors.forename: E
authors.initials: E
authors.lastname: Bandieri
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: D
authors.initials: D
authors.lastname: Sichetti
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: M
authors.initials: M
authors.lastname: Romero
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: C
authors.initials: C
authors.lastname: Fanizza
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: M
authors.initials: M
authors.lastname: Belfiglio
authors.affiliation: Palliative Care Unit Azienda Unitaria Sanitaria Locale (USL), Modena.
authors.forename: L
authors.initials: L
authors.lastname: Buonaccorso
authors.affiliation: Palliative Care Unit Azienda Unitaria Sanitaria Locale (USL), Modena.
authors.forename: F
authors.initials: F
authors.lastname: Artioli
authors.affiliation: Institute of Tanatologia, Clinica della crisi, I.A.T.S., University of Bologna, Bologna.
authors.forename: F
authors.initials: F
authors.lastname: Campione
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
authors.forename: G
authors.initials: G
authors.lastname: Tognoni
authors.affiliation: Department of Oncology, Hematology and Respiratory Diseases, Azienda Ospedaliera Universitaria, Policlinico, Modena, Italy. Electronic address: mario.luppi@unimore.it.
authors.forename: M
authors.initials: M
authors.lastname: Luppi
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007558:Italy; D008297:Male; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010166:Palliative Care / Q000379:methods*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid