title: Pain and its interference with daily activities in medical oncology outpatients.
abstract: BACKGROUND
  Pain prevalence at various stages of cancer ranges from 27% to 60% for outpatients. Yet, how pain is managed in this patient group is poorly understood.
  
  
  OBJECTIVE
  The primary objective was to assess pain prevalence and intensity, and its interference with daily activities, in medical oncology outpatients. The secondary objectives were the adequacy of analgesic pain treatment and to identify independent predictors for moderate to severe pain.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Oncology outpatient clinics of 7 Dutch regional hospitals.
  
  
  METHODS
  Four hundred twenty-eight medical oncology outpatients were assigned to the study. Pain prevalence and interference of pain with daily activities were assessed using the Brief Pain Inventory. Adequacy of analgesic treatment was determined by calculating the Pain Management Index (PMI). Descriptive statistics, non-parametric tests, and logistic regression analysis were conducted.
  
  
  RESULTS
  More than one third of all participants reported pain (39%). Eighty-three patients (20%) had moderate to severe pain (NRS 5-10). Analgesic treatment was inadequate in more than half of the patients with pain (62%). Interference of pain with daily activities increased with increased intensity, yet even 10%-33% of patients suffering mild pain reported high interference with daily activities. High current pain intensity and high interference with general daily activities predicted moderate to severe pain.
  
  
  CONCLUSIONS
  No characteristics of nonparticipants were available.
  
  
  CONCLUSIONS
  Pain remains a significant problem in medical oncology outpatients, and often pain is insufficiently managed. Patients with a high pain intensity were more at risk to experience pain related interference with daily activities, but even some patients suffering mild pain experienced this. As adequate pain relief for up to 86% of the patients with cancer should be feasible, pain in medical oncology outpatients is still undertreated. Taking into account the interference of pain with daily activities and predictors of pain will facilitate cancer pain management. The study has been approved by the Medical Ethics Committee (CMO) in all 7 hospitals (METC protocol number 2011/020) and has been registered by the Dutch Trial register (NTR): NTR2739.
authors.affiliation: Radboud University Nijmegen Medical Centre, Anaesthesiology, Pain and Palliative Medicine, Nijmegen, The Netherlands. n.faber-teboveldt@anes.umcn.nl
authors.forename: Nienke
authors.initials: N
authors.lastname: Te Boveldt
authors.forename: Myrra
authors.initials: M
authors.lastname: Vernooij-Dassen
authors.forename: Nathalie
authors.initials: N
authors.lastname: Burger
authors.forename: Michiel
authors.initials: M
authors.lastname: Ijsseldijk
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D010045:Outpatients / Q000706:statistics & numerical data*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics