Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study

Brunello, Antonella; Ahcene-Djaballah, Selma; Lettiero, Annunziata; Tierno, Giuseppina; Fiduccia, Pasquale; Guglieri, Irene; Dadduzio, Vincenzo; Maruzzo, Marco; Schiavon, Stefania; Zagonel, Vittorina

doi:10.1016/j.jgo.2019.01.005

Cited by 11 publications

(28 citation statements)

References 39 publications

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“…The main indications for daily opioid use were common conditions that have been associated previously with both opioid use and pain in older home care clients [7,9,30] and community-dwelling older adults [3][4][5]. The small proportion (3.2%) of use for malignant pain in this study is consistent with the previous finding that among aged cancer patients, only about half of the current pain is cancer-related [31] and only 6.4% of the opioid users had current cancer. However, this emphasizes the increasing trend of non-malignant indications for opioid use.…”

Section: Discussionsupporting

confidence: 88%

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

et al. 2020

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Background The increasing trend of opioid use for non-malignant pain among older people has raised concerns about whether opioids are used for appropriate indications. On the other hand, pain in patients with dementia may be undertreated. Aims To examine the prevalence of and indications for daily opioid use among home care clients, and to determine opioid use differs between those with and without dementia. Methods All home care clients aged ≥ 65 years using opioids daily (n = 282) were identified based on their first Resident Assessment Instrument-Home Care assessment in 2014. Exact indications for opioid use, the opioid substance used, the median duration of use, and changes in opioid medication within 12 months from study entry were obtained from the electronic medical records. Results The prevalence of daily opioid use was 9.3%, and the median duration of use before the study entry was 357 days (interquartile range 126-719 days). The majority of clients continued to use opioids daily during the follow-up year. Vertebral osteoporotic fractures (21.6%), degenerative spinal disorders (20.9%), and osteoarthritis (20.6%) were the most common indications for opioid use. Buprenorphine was used more frequently in persons with dementia, but otherwise there were no differences between those with and without dementia. Discussion and conclusions Home care clients use opioids for long periods of time for pain related mostly to musculoskeletal disorders, although the effectiveness of long-term opioid use is not clear. The lack of effective or suitable options for management of pain might explain the situation.

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Section: Discussionsupporting

confidence: 88%

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

et al. 2020

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“…Our results showed a prevalence of frailty in EGP of 35%, which is much higher than what is expected in the overall elderly population; according to a previous systematic review of frailty in community-dwelling older adults, data collected using CGA demonstrated 13.6% as frail patients [28]. On the other hand, comparing our results to elderly patients with other tumor types, we can see a lower prevalence of frailty and a higher rate of fit patients among EGP; a recent study categorized 745 patients with gastrointestinal, breast, and urological cancer as “frail” in 45%, as “vulnerable” in 34%, and as “fit” in 20% of the cases [29]…”

Section: Discussionmentioning

confidence: 49%

Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Lombardi

Bergo

Caccese

et al. 2019

Cancers

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Background: Treatment of elderly glioblastoma patients (EGP) is a challenge in neuro-oncology. The comprehensive geriatric assessment (CGA) is currently used to assess geriatric oncological patients with other types of tumors. We performed a large retrospective study to analyze its predictive role in EGP. Methods: Patients aged ≥65 years with histologically confirmed diagnosis of glioblastoma were enrolled. CGA included the following tests: the Cumulative Illness Rating Scale-Comorbidity and Severity Index, Activities of Daily Living, Instrumental Activities of Daily Living, the Mini Mental State Examination, and the Geriatric Depression Scale. Based on CGA results, each patient was categorized as fit, vulnerable, or frail. Results: We enrolled 113 patients. According to the CGA scores, 35% of patients were categorized as “fit”, 30% as “vulnerable”, and 35% as “frail” patients. Median overall survival was 16.5, 12.1, and 10.3 months in fit, vulnerable, and frail patients (p = 0.1), respectively. On multivariate analysis, the CGA score resulted an independent predictor of survival; indeed, vulnerable and frail patients had a hazard ratio of 1.5 and 2.2, respectively, compared to fit patients (p = 0.04). No association between CGA and progression-free survival (PFS) was demonstrated. Conclusions: The CGA score proved to be a significant predictor of mortality in EGP, and it could be a useful treatment decision tool.

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“…Few previous studies of patients with LC reported a relationship between pain and cognitive functioning. However, previous studies of patients with cancer found that patients who had more pain had impaired cognitive functioning [41,[45][46][47]. According to the previous studies, sustained pain, use of analgesics, and reporting more incidents or greater severity of pain are all associated with decreased cognitive functioning.…”

Section: Discussionmentioning

confidence: 95%

Relationships of Symptom Groups and Functioning Domains in Patients with Advanced-Stage Non-Small Cell Lung Cancer Undergoing Treatment: A Cross-Sectional Study

Lee

2020

Healthcare

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The purpose of this study was to describe the symptoms experienced by patients with non-small cell lung cancer (NSCLC), examine whether different symptom groups significantly affected different functioning domains in these patients, and determine the effect of the “lack of energy” and “pain” symptom groups on the different functioning domains of health-related quality of life (HRQOL). From a single tertiary institution, this cross-sectional study enrolled 135 consecutive NSCLC patients who were mostly undergoing chemotherapy and were in the advanced stage (National University Hospital, Daegu, South Korea). Clinical and self-reported demographic information and data on different functioning domains (from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)), symptom experience (from the EORTC QLQ-LC13), and the Symptom Distress Scale (SDS) were examined. The four most common symptoms were fatigue (69%), pain (47%), dyspnea (38%), and lack of appetite (36%). The “pain” symptom group was negatively associated with physical, emotional, cognitive, and role functioning. The “lack of energy” symptom group was negatively associated with physical, role, emotional, social, and cognitive functioning. The “lack of energy” symptom group explained the most variance for physical and role functioning, and the “pain” symptom group explained the most variance for emotional functioning. Impaired concentration explained the most variance for cognitive functioning.

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Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study

Cited by 11 publications

References 39 publications

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Relationships of Symptom Groups and Functioning Domains in Patients with Advanced-Stage Non-Small Cell Lung Cancer Undergoing Treatment: A Cross-Sectional Study

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Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study

Cited by 11 publications

References 39 publications

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

The prevalence of and exact indications for daily opioid use among aged home care clients with and without dementia

Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Relationships of Symptom Groups and Functioning Domains in Patients with Advanced-Stage Non-Small Cell Lung Cancer Undergoing Treatment: A Cross-Sectional Study

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Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study