Oncology Outpatients with Cancer-Related Pain Require More Than Around The Clock (ATC) Dosing of Analgesics to Achieve Adequate Analgesia

2.50
Hdl Handle:
http://hdl.handle.net/10755/165689
Category:
Abstract
Type:
Presentation
Title:
Oncology Outpatients with Cancer-Related Pain Require More Than Around The Clock (ATC) Dosing of Analgesics to Achieve Adequate Analgesia
Author(s):
Miaskowski, Christine
Author Details:
Christine Miaskowski, PhD, Professor, University of California-San Francisco, School of Nursing, San Francisco, California, USA, email: chris.miaskowski@nursing.ucsf.edu
Abstract:
The use of ATC dosing of analgesics is a fundamental tenet in the management of cancer-related pain. However, no studies have compared changes in pain intensity scores, over time, in patients who were using an ATC dosing regimen compared to patients who were using an “as needed” (i.e., PRN) dosing regimen. The purposes of this descriptive, longitudinal study were to determine if there were differences in pain intensity scores and differences in does of opioid analgesics prescribed and taken between oncology outpatients with bone metastasis who were taking analgesic on an ATC (n=74) or on a prescribed and if they took >80% of the ATC dose for 5 weeks. No differences were found in any of the demographic or disease characteristics between patients in the two groups except that patients in the ATC group had a lower Karnofsky Performance Scale Score than patients in the PRN group. Four separate two-way repeated measures analysis of variance (ANOVAs) found no significant group by time interactions in average, least, or worst pain scores or in the number of hours per day in pain indicating over the five weeks of data collection the two groups did not differ on any of the pain measures. In contrast, patients in the ATC group were prescribed and were taking significantly higher doses of opioid analgesics (i.e., prescription does was 7 times higher and dose taken was 21 times higher) than patients in the PRN group. The findings from this study have significant clinical implications and provide directions for future research. Potential explanations for the lack of differences in pain intensity scores between the two groups include: a lack of titration of analgesics to effect, the pain medication regimen is not an effective treatment for pain from bone metastasis, or pain intensity scores may not be the appropriate method for evaluating the effectiveness of analgesic regimens.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleOncology Outpatients with Cancer-Related Pain Require More Than Around The Clock (ATC) Dosing of Analgesics to Achieve Adequate Analgesiaen_GB
dc.contributor.authorMiaskowski, Christineen_US
dc.author.detailsChristine Miaskowski, PhD, Professor, University of California-San Francisco, School of Nursing, San Francisco, California, USA, email: chris.miaskowski@nursing.ucsf.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165689-
dc.description.abstractThe use of ATC dosing of analgesics is a fundamental tenet in the management of cancer-related pain. However, no studies have compared changes in pain intensity scores, over time, in patients who were using an ATC dosing regimen compared to patients who were using an “as needed” (i.e., PRN) dosing regimen. The purposes of this descriptive, longitudinal study were to determine if there were differences in pain intensity scores and differences in does of opioid analgesics prescribed and taken between oncology outpatients with bone metastasis who were taking analgesic on an ATC (n=74) or on a prescribed and if they took >80% of the ATC dose for 5 weeks. No differences were found in any of the demographic or disease characteristics between patients in the two groups except that patients in the ATC group had a lower Karnofsky Performance Scale Score than patients in the PRN group. Four separate two-way repeated measures analysis of variance (ANOVAs) found no significant group by time interactions in average, least, or worst pain scores or in the number of hours per day in pain indicating over the five weeks of data collection the two groups did not differ on any of the pain measures. In contrast, patients in the ATC group were prescribed and were taking significantly higher doses of opioid analgesics (i.e., prescription does was 7 times higher and dose taken was 21 times higher) than patients in the PRN group. The findings from this study have significant clinical implications and provide directions for future research. Potential explanations for the lack of differences in pain intensity scores between the two groups include: a lack of titration of analgesics to effect, the pain medication regimen is not an effective treatment for pain from bone metastasis, or pain intensity scores may not be the appropriate method for evaluating the effectiveness of analgesic regimens.en_GB
dc.date.available2011-10-27T12:23:10Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:23:10Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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