title: Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients.
abstract: BACKGROUND
  Pain in cancer patients is recognized as a major health problem, yet few studies of both inpatient and outpatient populations have been carried out.
  
  
  OBJECTIVE
  The study objective was to assess the frequency, type, and characteristics of pain in adult cancer patients, including both inpatients and outpatients.
  
  
  METHODS
  This cross-sectional study involved 1064 adult cancer patients (437 outpatients and 627 inpatients) from 44 hospitals and/or long-term-care centers in Catalonia, Spain. Cancer patients suffering from pain of any etiology for ≥2 weeks and/or under analgesic treatment ≥2 weeks were enrolled. Demographic and pain data were collected. The Spanish version of the Brief Pain Inventory was used to assess pain.
  
  
  RESULTS
  Pain frequency was 55.3%. Pain was less frequent in outpatients than inpatients (41.6% versus 64.7%; p<0.001), although median pain duration was longer in outpatients (20 versus 6 weeks; p<0.001). Pain was assessable in 333 patients, and intensity was similar in both out- and inpatients; however, outpatients reported less improvement, less pain interference with daily life, and less pain related to the cancer per se. In both groups, patients with multiple myeloma (73%), breast (65%), and lung cancer (61%) were most likely to report pain.
  
  
  CONCLUSIONS
  Pain in cancer patients, both ambulatory and hospitalized, remains a challenge for health care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, a problem that is particularly notable in outpatients due to the intensity and duration of the pain.
authors.affiliation: 1 Palliative Care Service, Catalan Institute of Oncology , Barcelona, Spain .
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
authors.affiliation: 2 Palliative Care Department, University Hospital Arnau de Vilanova , Lleida, Spain .
authors.forename: Maria
authors.initials: M
authors.lastname: Nabal-Vicuna
authors.affiliation: 3 Clinical Pharmacology Department, University Hospital Bellvitge , Spain .
authors.forename: Antonio
authors.initials: A
authors.lastname: Vallano
authors.affiliation: 4 The Qualy Observatory, Barcelona, Spain .
authors.forename: Jose
authors.initials: J
authors.lastname: Espinosa
authors.affiliation: 5 Palliative Care Department, Hospital del Mar , Barcelona, Spain .
authors.forename: Josep
authors.initials: J
authors.lastname: Planas-Domingo
authors.affiliation: 6 Radiation Oncology Department, Hospital Clinic , Barcelona, Spain .
authors.forename: Eugènia
authors.initials: E
authors.lastname: Verger-Fransoy
authors.affiliation: 1 Palliative Care Service, Catalan Institute of Oncology , Barcelona, Spain .
authors.forename: Joaquim
authors.initials: J
authors.lastname: Julià-Torras
authors.affiliation: 7 Palliative Care Department, University Hospital Vall d'Hebron , Barcelona, Spain .
authors.forename: Judith
authors.initials: J
authors.lastname: Serna
authors.affiliation: 8 Palliative Care Department, University Hospital de la Sta. Creu i St. Pau , Barcelona, Spain .
authors.forename: Antonio
authors.initials: A
authors.lastname: Pascual-López
authors.affiliation: 9 Palliative Care Department, University Hospital St. Joan , Reus, Spain .
authors.forename: Dulce
authors.initials: D
authors.lastname: Rodríguez
authors.affiliation: 10 Palliative Care Department, Parc Taulí Health Coorporation , Sabadell, Spain .
authors.forename: Isidre
authors.initials: I
authors.lastname: Grimau
authors.affiliation: 11 Palliative Care Department, Hospital Asil de Granollers , Granollers, Spain .
authors.forename: Germà
authors.initials: G
authors.lastname: Morlans
authors.affiliation: 12 Palliative Care Department, Terrassa Health Consortium , Terrassa, Spain .
authors.forename: Carme
authors.initials: C
authors.lastname: Sala-Rovira
authors.affiliation: 1 Palliative Care Service, Catalan Institute of Oncology , Barcelona, Spain .
authors.forename: Agnes
authors.initials: A
authors.lastname: Calsina-Berna
authors.affiliation: 13 Department of Clinical Sciences, University of Barcelona , Barcelona, Spain .
authors.forename: Josep Ma
authors.initials: JM
authors.lastname: Borras-Andrés
authors.affiliation: 14 WHO Collaborating Centre for Public Health Palliative Care Programmes , Barcelona, Spain .
authors.forename: Xavier
authors.initials: X
authors.lastname: Gomez-Batiste
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010045:Outpatients / Q000706:statistics & numerical data; D010146:Pain / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D059408:Pain Management / Q000379:methods / Q000592:standards*; D010147:Pain Measurement; D015995:Prevalence; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D055815:Young Adult