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Pain patients' retrospective reports of pain are important to physicians and other health professionals in helping to decide on future treatment plans. Unfortunately patients' memory of pain can be inaccurate and subject to overestimation. This study examined variables which influenced accuracy of remembering pain in 93 chronic pain patients. The patients were initially evaluated by a physician and completed a comprehensive pain questionnaire and an SCL-90. All patients were asked to monitor their pain intensity every hour for 1 week. At the end of this period each patient was asked to estimate their average pain intensity ratings for 4 times during the day for the previous week. These estimations were compared with the actual mean pain ratings. Results showed that most patients tended to overestimate their pain intensity levels. Cervical and low back pain patients were found to be more accurate than headache and abdominal pain patients in remembering their pain. Patients who reported more emotional distress, who had conflicts at home, who were less active and who relied on medication tended to be the most inaccurate in remembering their pain.

CR oxycodone every 12 hours was as effective as IR oxycodone four times daily in managing moderate to severe cancer-related pain and was associated with fewer reports of adverse events.

We conducted a study of the safety of controlled-release (CR) oxycodone tablets (OxyContin Tablets) administered chronically to patients with cancer-related pain in a usual clinical setting. These patients had participated in 1 of 2 double-blind, active-control studies. Our study was an open, 3-month treatment study that included 87 patients. Patients received CR oxycodone tablets every 12 hr in a manner that reflected typical clinical practice. Supplemental immediate-release (IR) oxycodone was available PRN for breakthrough pain. Patients recorded medication use, adverse events, and evaluations of pain intensity and acceptability of therapy in a daily diary. Forty-four patients (51%) completed all 12 weeks of study; 43 patients (49%) discontinued participation. At baseline and throughout the study period, the overall mean pain-intensity score was slight to moderate. A comparison of initial and final doses showed a significant but modest increase in total daily CR oxycodone dose. An increase or decrease in titration of the oxycodone dose occurred for 66 patients (84%) at least once during the 12-week study period, primarily for increased pain. Forty-four patients (56%) did not undergo dose titration when the latter was indicated. Half of the patients used IR oxycodone rescue almost daily; the mean number of rescue doses per day was 1.5. Despite stable pain control and an increasing total daily CR oxycodone dose, the percentage of patients reporting common opioid-related adverse events decreased over the course of the study. CR oxycodone tablets administered every 12 hr were successfully used to manage cancer pain over a 12-week period. Importantly, side effects diminished over time without a concomitant change in efficacy.

This study examined concentration and memory problems in chronic pain patients as they related to emotional distress and interference with daily activity. Three hundred and sixty-three chronic pain patients were divided into two groups based on how much they expressed difficulty in concentrating and remembering things. Each patient was given a physical examination and completed a pain evaluation questionnaire and an SCL-90. Physician ratings of the patients' depression and anxiety were also obtained. The results showed that problems in concentration and memory were related to emotional distress, poor family support, and interference with daily activities. It is suggested that techniques to improve concentration and memory should be incorporated as part of a multidisciplinary pain program.

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Four hundred fifty-three chronic pain patients completed a Symptom Checklist 90 (SCL-90) and a comprehensive pain evaluation questionnaire. All patients were evaluated by a physician and rated on degree of pain pathology and pain behavior. The SCL-90 data were analyzed using two clustering procedures and replicated over two similar samples. Three distinct profiles emerged and represented high, medium, and low scores on the SCL-90. No differences were found between subgroups on demographic characteristics, compensation status, pain duration, or pain ratings. Patients in the high-profile subgroup showed the most emotional distress, reported that their pain interfered the most with all activities, and were most often judged to have high pain behavior. Little evidence was found to support a "denial" profile, as previously predicted. Further support was found for using the SCL-90 in assessing chronic pain patients.