Factors related to pain management adequacy in patients receiving palliative care: data from a tertiary hospital in Indonesia

Shatri, Hamzah; Agung, Ratih Arianita; Abdullah, Vera Iriani; Elita, Dina; Putranto, Rudi; Adli, Mizanul; Irawan, Cosphiadi

doi:10.13181/mji.oa.204088

Cited by 5 publications

(10 citation statements)

References 21 publications

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“…Included studies 16,17,24,25,53–87 were published from 1999 to 2022 across 16 countries, with most studies conducted in Asia or Australia ( n = 26), followed by Europe ( n = 9) and the Americas ( n = 4). Twenty-three were prospective studies and 16 were retrospective.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included a mix of primary cancers, while six investigated a particular type of cancer. 61,68,74,81,83,87 Most studies reported discrimination measures, while two studies reported good calibration using the Hosmer-Lemeshow test ( p > 0.05) 65,85 and calibration plot ( R 2 = 0.799, p < 0.001). 85 Only one study reported reclassification measures.…”

Section: Resultsmentioning

confidence: 99%

“…61,68,74,81,83,87 Most studies reported discrimination measures, while two studies reported good calibration using the Hosmer-Lemeshow test (p > 0.05) 65,85 and calibration plot (R 2 = 0.799, p < 0.001). 85 Only one study reported reclassification measures. 70 Fifteen studies investigated PPI in comparison with other tools -clinician predicted survival, 17,54,70,73,75,82,86,87 Palliative Prognostic Score, 25,54,56,64,65,73,75,82 Delirium-Palliative Prognostic Score, 56,64,65 PPS, 25,56,75 Prognosis in Palliative Care Study, 65,82 Objective Prognostic Score, 64,73,82 Performance Status-Based PPI, 69,76 Biological Prognostic Score 74 and Chinese Prognostic Scale.…”

Section: Includedmentioning

confidence: 99%

“…All had high ROB in the 'analysis' domain, as most studies did not report calibration except for two studies. 65,85 Shatri et al 85 conducted a Hosmer-Lemeshow test and constructed a calibration plot prior to making conclusion that PPI was well-calibrated. Baba et al 65 merely reported that Hosmer-Lemeshow test was insignificant in two settings (hospital palliative care team and palliative care unit).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

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Performance of the Palliative Prognostic Index for cancer patients: A systematic review and meta-analysis

Yoong,

Porock,

Whitty

et al. 2023

Palliat Med

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Background: Clinician predicted survival for cancer patients is often inaccurate, and prognostic tools may be helpful, such as the Palliative Prognostic Index (PPI). The PPI development study reported that when PPI score is greater than 6, it predicted survival of less than 3 weeks with a sensitivity of 83% and specificity of 85%. When PPI score is greater than 4, it predicts survival of less than 6 weeks with a sensitivity of 79% and specificity of 77%. However, subsequent PPI validation studies have evaluated various thresholds and survival durations, and it is unclear which is most appropriate for use in clinical practice. With the development of numerous prognostic tools, it is also unclear which is most accurate and feasible for use in multiple care settings. Aim: We evaluated PPI model performance in predicting survival of adult cancer patients based on different thresholds and survival durations and compared it to other prognostic tools. Design: This systematic review and meta-analysis was registered in PROSPERO (CRD42022302679). We calculated the pooled sensitivity and specificity of each threshold using bivariate random-effects meta-analysis and pooled diagnostic odds ratio of each survival duration using hierarchical summary receiver operating characteristic model. Meta-regression and subgroup analysis were used to compare PPI performance with clinician predicted survival and other prognostic tools. Findings which could not be included in meta-analyses were summarised narratively. Data sources: PubMed, ScienceDirect, Web of Science, CINAHL, ProQuest and Google Scholar were searched for articles published from inception till 7 January 2022. Both retrospective and prospective observational studies evaluating PPI performance in predicting survival of adult cancer patients in any setting were included. The Prediction Model Risk of Bias Assessment Tool was used for quality appraisal. Results: Thirty-nine studies evaluating PPI performance in predicting survival of adult cancer patients were included ( n = 19,714 patients). Across meta-analyses of 12 PPI score thresholds and survival durations, we found that PPI was most accurate for predicting survival of <3 weeks and <6 weeks. Survival prediction of <3 weeks was most accurate when PPI score>6 (pooled sensitivity = 0.68, 95% CI 0.60–0.75, specificity = 0.80, 95% CI 0.75–0.85). Survival prediction of <6 weeks was most accurate when PPI score>4 (pooled sensitivity = 0.72, 95% CI 0.65–0.78, specificity = 0.74, 95% CI 0.66–0.80). Comparative meta-analyses found that PPI performed similarly to Delirium-Palliative Prognostic Score and Palliative Prognostic Score in predicting <3-week survival, but less accurately in <30-day survival prediction. However, Delirium-Palliative Prognostic Score and Palliative Prognostic Score only provide <30-day survival probabilities, and it is uncertain how this would be helpful for patients and clinicians. PPI also performed similarly to clinician predicted survival in predicting <30-day survival. However, these findings should be interpreted with caution as limited studies were available for comparative meta-analyses. Risk of bias was high for all studies, mainly due to poor reporting of statistical analyses. while there were low applicability concerns for most (38/39) studies. Conclusions: PPI score>6 should be used for <3-week survival prediction, and PPI score>4 for <6-week survival. PPI is easily scored and does not require invasive tests, and thus would be easily implemented in multiple care settings. Given the acceptable accuracy of PPI in predicting <3- and <6-week survival and its objective nature, it could be used to cross-check clinician predicted survival especially when clinicians have doubts about their own judgement, or when clinician estimates seem to be less reliable. Future studies should adhere to the reporting guidelines and provide comprehensive analyses of PPI model performance.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Includedmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

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Performance of the Palliative Prognostic Index for cancer patients: A systematic review and meta-analysis

Yoong,

Porock,

Whitty

et al. 2023

Palliat Med

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show abstract

“…Interestingly, an abbreviated form of the Palliative Prognostic Index that simplifies the diagnosis of delirium was found to be predictive for patients with advanced cancer in a home hospice setting in South Korea [29]. Studies in Asian countries generally show good and comparable prognostic accuracy between the Palliative Prognostic Index and other systems or clinical prediction in predicting short-term survival in acute or palliative ward settings across various cancer types [19,23,[28][29][30][31][32][33][34].…”

Section: Palliative Prognostic Indexmentioning

confidence: 99%

Survival prediction in advanced cancer patients – a narrative review

Lee

Simone

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewThe exploration for accurate ways to predict survival for advanced cancer patients continues to be a significant theme despite the advent of objective criteria and their combination with clinical criteria. The purpose of this article was to review some of the latest studies relating to prognostication and the capacity to predict survival during the terminal cancer stage. Recent findingsRecent studies show notable prognostication approaches using genetic tests and advanced computation methods such as machine learning, which we will summarize.

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Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

Mihiretie,

Siyum,

Tamene

2024

BMJ Open

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ObjectiveThe aim of this study was to assess the adequacy of cancer-related pain (CRP) management and associated factors among patients with cancer in the Northwest oncology centres of Ethiopia.Design and settingAn institutional-based multicentre cross-sectional study was conducted among patients with cancer in the Northwest oncology centres of Ethiopia from May to July 2022.ParticipantsAll oncology patients at selected hospitals who fulfilled the inclusion criteria during the data collection period were the study population.Main outcome measuresThe main outcome of this study was the adequacy of CRP management, which was measured by the Pain Management Index (PMI). A systematic random sampling technique was used to select representatives from each study area. Data entry and analysis were done using EpiData V.4.6.1 and SPSS V.26, respectively. Binary logistic regression was conducted to determine independent predictors of the adequacy of CRP management. A p value of <0.05 was considered statistically significant.ResultsFrom a total of 422 included respondents, about 67.5% of the participants had adequate CRP management (95% CI 62.8 to 72). Good performance status (adjusted OR (AOR)=0.44; 95% CI 0.24 to 0.80), presence of comorbidity (AOR=3.28; 95% CI 1.68 to 6.38) and pain history (AOR=0.33; 95% CI 0.01 to 0.11) were significantly associated with the adequacy of cancer pain management.ConclusionUsing PMI status in the Northwest oncology centre of Ethiopia, more than two-thirds of patients with CRP obtained adequate pain management. The adequacy of CRP management was found to be influenced by factors like comorbidity, past pain history and Eastern cooperative oncology group performance status.

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Factors related to pain management adequacy in patients receiving palliative care: data from a tertiary hospital in Indonesia

Cited by 5 publications

References 21 publications

Performance of the Palliative Prognostic Index for cancer patients: A systematic review and meta-analysis

Performance of the Palliative Prognostic Index for cancer patients: A systematic review and meta-analysis

Survival prediction in advanced cancer patients – a narrative review

Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

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