title: Follow-up Visits and Changes in Pain Scores Reported by Oncology Outpatients After Initial Presentation With Severe Pain.
abstract: BACKGROUND
  In addition to tumour treatment, the management of symptoms such as pain is an important component of cancer care. Pain management is a complex field and prior studies have highlighted many different clinical care responses to a cancer patient presenting with severe pain. We explored follow-up and how pain screening scores changed over time, among a cohort of cancer outpatients, and how follow-up was scheduled after the initial visit.
  
  
  METHODS
  The care provided to 96 patients seen at the London Regional Cancer Program was reviewed for the 12-week period following presentation with severe pain >7/10. Follow-up ESAS (Edmonton Symptom Assessment System) scores, visits, and compliance were documented.
  
  
  RESULTS
  Follow-up ESAS data was available for 41/96 patients. Mean ESAS pain decreased from 8.4/10 to 3.6/10 among those patients with follow-up; however, for 55/96 patients, no follow-up ESAS score was available (deceased n=3, no follow-up visit n=41, no pain score reported, n=11).
  
  
  CONCLUSIONS
  Despite a very high proportion of documented active pain management plans in the case of cancer patients presenting with severe pain, very little follow-up directed specifically at pain management was performed. Cancer treatment appears to be the primary determinant of oncology follow-up timing at our centre.
authors.affiliation: Medical Oncology, Schulich School of Medicine & Dentistry, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Brett
authors.initials: B
authors.lastname: Hill
authors.affiliation: Neuro-oncology, Schulich School of Medicine & Dentistry, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Dwight
authors.initials: D
authors.lastname: Moulin
authors.affiliation: Medical Oncology, Schulich School of Medicine & Dentistry, London Regional Cancer Program, Western University, London, Ontario, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sanatani
keywords: cancer pain; follow-up; symptom management