Assessment of pain control in advanced cancer patients admitted to a palliative care unit

Abstract

Introduction: Pain in people with cancer is prevalent and should have an individualized therapeutic plan. Objectives: To evaluate pain control in advanced cancer patients in a hospital palliative care unit. Methods: This is a cohort study, with prospective design, and quantitative approach, including advanced cancer patients admitted to a palliative care unit between June 2021 and February 2022 reporting pain. Data was collected from medical records and the Brief Pain Inventory (BPI) was used to assess pain on the first (D1), third (D3) and seventh (D7) day of hospitalization. Results: One hundred and four patients participated in the study. The most prevalent tumors were of the gastrointestinal tract (n=23; 22%), cervix (n=21; 20%) and breast (n=17; 16%). Abdomen was the most reported site of pain (n=34; 33%), with 50% classified as nociceptive pain, 39% neuropathic pain, and 11% mixed. On D1, 43% reported severe pain, 31% moderate, and 12% mild pain. There was an evolutionary drop in the percentage of severe pain (BPI3 70% to 37.1%; BPI4 12.6% to 5.4%; BPI5 42.5% to 13.5%; and BPI9 67.8% to 21.6%) according to the answers to all BPI questions during the period. On D1, D3 and D7, the average equipotent doses of oral morphine were 116 mg, 133 mg and 154 mg and the frequency of use of adjuvant use was 60%, 75%, and 69%, respectively. Conclusions: Pain was properly controlled and was related to the increased use of adjuvants, both for general and neuropathic pain. It was possible to observe that the use of adjuvants was related to better pain control.