Pain in Palliative Cancer Patients – Analysis of the German National Palliative Care Registry

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY Journal of pain and symptom management Pub Date : 2025-02-01 DOI:10.1016/j.jpainsymman.2024.10.030
Markus Ramm PhD , Man Long Chung MSc , Kathrin Schnabel PhD , Alexander Schnabel MD , Johanna Jedamzik MD , Michaela Hesse PhD , Michaela Hach , Lukas Radbruch MD , Martin Mücke MD , Rupert Conrad MD
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Abstract

Context

Palliative care aims to improve the quality of life in patients with progressive diseases such as cancer. Effective cancer pain management is a major challenge of palliative treatment. Empirical data on the prevalence of cancer pain, the efficiency of pain treatment and influencing factors are scarce.

Objectives

Here, we investigated pain in cancer patients treated on inpatient palliative care wards in Germany.

Methods

N = 4779 data sets provided by the German Palliative Care Registry from yearly evaluation periods between 2015 and 2020 were included. Pain ratings were assessed by professionals through a checklist of symptoms and problems (HOPE-SP-CL).

Results

More than half of the included patients suffered from moderate/severe pain at the beginning of inpatient palliative care and in 71% of these patients, pain relief was achieved at the end of inpatient treatment. Pain intensity, depression and ECOG performance status at admission were weak predictors of later pain relief. The highest pain intensity at the beginning and least pain relief were found in patients with bone and cartilage cancer. The highest percentage of adequate pain control (81%) was seen in 2020.

Conclusion

Data from the German Palliative Care Registry confirmed that although increasingly better addressed over the years, insufficiently controlled cancer pain remains a challenge for palliative care units. Patient-specific (e.g. psychological comorbidity) and cancer-related (e.g. bone or cartilage cancer) risk factors for poor pain treatment underline the need for individualized multimodal pain management including psychological support.
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癌症姑息治疗患者的疼痛--对德国国家姑息治疗登记处的分析。
背景:姑息治疗旨在改善癌症等进展性疾病患者的生活质量。有效的癌痛管理是姑息治疗的一大挑战。有关癌症疼痛的发生率、疼痛治疗的效率和影响因素的经验数据很少:在此,我们调查了在德国住院姑息治疗病房接受治疗的癌症患者的疼痛情况:方法:纳入德国姑息治疗登记处提供的 2015 年至 2020 年期间每年评估的 N = 4779 组数据。专业人员通过症状和问题清单(HOPE-SP-CL)对疼痛评分进行评估:结果:一半以上的患者在住院姑息治疗开始时患有中度/重度疼痛,其中71%的患者在住院治疗结束时疼痛得到缓解。入院时的疼痛强度、抑郁和ECOG表现状态对日后疼痛缓解的预测作用较弱。骨癌和软骨癌患者开始时的疼痛强度最高,疼痛缓解程度最低。2020年疼痛得到充分控制的比例最高(81%):来自德国姑息治疗登记处的数据证实,尽管多年来对癌症疼痛的处理越来越好,但疼痛控制不足仍是姑息治疗部门面临的一项挑战。患者特异性(如心理并发症)和癌症相关性(如骨癌或软骨癌)是导致疼痛治疗效果不佳的风险因素,这凸显了个性化多模式疼痛管理(包括心理支持)的必要性。
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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