title: Cancer pain management in an oncological ward in a comprehensive cancer center with an established palliative care unit.
abstract: BACKGROUND
  This 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.
  
  
  METHODS
  Cross-sectional survey in an oncological department performed 1 day per month for six consecutive months.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  It 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.
authors.affiliation: 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.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.forename: Costanza
authors.initials: C
authors.lastname: Guccione
authors.forename: Simona
authors.initials: S
authors.lastname: Di Fatta
authors.forename: Valentina
authors.initials: V
authors.lastname: Alaimo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Prestia
authors.forename: Rosanna
authors.initials: R
authors.lastname: Bellingardo
authors.forename: Vittorio
authors.initials: V
authors.lastname: Gebbia
authors.forename: Antonino
authors.initials: A
authors.lastname: Giarratano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casuccio
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D059390:Breakthrough Pain / Q000188:drug therapy / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D015995:Prevalence; D055815:Young Adult
chemical_list: D000700:Analgesics