Oncology outpatients with pain from bone metastasis require more than around-the-clock dosing of analgesics to achieve adequate pain control

Christine Miaskowski, Kayee Alice Mack, Marylin Dodd, Claudia West, Steven M. Paul, Debu Tripathy, Peter Koo, Karen Schumacher, Noreen Facione

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Around-the-clock (ATC) dosing of opioid analgesics is the established approach for the management of chronic cancer pain. The purposes of this study were to determine whether there were differences in pain intensity scores and pain duration between oncology outpatients who were taking opioid analgesics on an around-the-clock (ATC) compared with an as needed (PRN) basis and to determine differences in opioid prescription and consumption between the 2 groups during a period of 5 weeks. Oncology patients (n = 137) with pain from bone metastasis were recruited from 7 outpatient settings. Patients completed a demographic questionnaire and on a daily basis recorded pain intensity scores and medication intake in a diary. No significant differences in average, least, or worst pain intensity scores or number of hours per day in pain were found between the 2 groups. However, the average total opioid dose, prescribed and taken, was significantly greater for the ATC group than for the PRN group. These findings suggest the need for further investigations in the following areas: the appropriate treatments for pain related to bone metastasis, the use of various pain measures to evaluate the effectiveness of analgesic medications, and the need to evaluate how analgesics are prescribed and titrated for patients with cancer-related pain.

Original languageEnglish (US)
Pages (from-to)12-20
Number of pages9
JournalJournal of Pain
Volume3
Issue number1
DOIs
StatePublished - Jan 1 2002
Externally publishedYes

Keywords

  • Around-the-clock administration
  • As needed administration
  • Cancer pain
  • Opioid analgesics

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Miaskowski, C., Mack, K. A., Dodd, M., West, C., Paul, S. M., Tripathy, D., Koo, P., Schumacher, K., & Facione, N. (2002). Oncology outpatients with pain from bone metastasis require more than around-the-clock dosing of analgesics to achieve adequate pain control. Journal of Pain, 3(1), 12-20. https://doi.org/10.1054/jpai.2002.27002