Dongjie Chen M.S., Dianjun Chen M.S., Haitao Sun M.D., Danhui You M.D., Haochun Tang M.D., Shupei Li M.D., Peng Song M.D., Songfeng Xu M.D., Lihong Guo M.D., Li Sun M.D., Boyan Yang M.D., Jun Liang M.D.
{"title":"Efficacy of Multidisciplinary Pain Management for Advanced Cancer Patients","authors":"Dongjie Chen M.S., Dianjun Chen M.S., Haitao Sun M.D., Danhui You M.D., Haochun Tang M.D., Shupei Li M.D., Peng Song M.D., Songfeng Xu M.D., Lihong Guo M.D., Li Sun M.D., Boyan Yang M.D., Jun Liang M.D.","doi":"10.1016/j.pmn.2025.01.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study is to assess the efficacy and affecting factors of a multidisciplinary team (MDT) on cancer-related pain in patients with advanced cancer.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on patients receiving pain management from November 2018 to December 2023 by the MDT. Pain intensity, pain management index (PMI), pain response, and Barthel index of activities of daily living (BADL) were assessed at baseline and/or after 2 weeks of MDT interventions. Univariate and multiple logistic analyses were conducted to identify risk indicators for pain response.</div></div><div><h3>Results</h3><div>After interventions, pain intensity, numerical rating scale (NRS) scores, and PMI significantly improved in all patients (<em>p</em> < .001). Subgroup analyses revealed that pain intensity and NRS scores were notably reduced, while PMI increased after the interventions in the responders (<em>p</em> < .001). Conversely, no significant changes were observed in pain intensity, NRS scores, or PMI for the nonresponders following MDT intervention. MDT interventions did not lead to improvements in BADL for either group. Patients who underwent radiotherapy exhibited a significantly higher overall response rate (ORR) compared to those without radiotherapy (100% vs 60.8%, <em>p</em> = .033). In univariate analysis, lower KPS scores and visceral pain showed negative associations with pain response. However, in multivariate analysis, neither maintained significance.</div></div><div><h3>Conclusions</h3><div>The pain MDT demonstrated remarkable improvements in clinical management and pain control. Further prospective studies are warranted to investigate predictive factors associated with pain treatment.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 3","pages":"Pages 349-357"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Management Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1524904225000025","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
The objective of this study is to assess the efficacy and affecting factors of a multidisciplinary team (MDT) on cancer-related pain in patients with advanced cancer.
Methods
A retrospective analysis was performed on patients receiving pain management from November 2018 to December 2023 by the MDT. Pain intensity, pain management index (PMI), pain response, and Barthel index of activities of daily living (BADL) were assessed at baseline and/or after 2 weeks of MDT interventions. Univariate and multiple logistic analyses were conducted to identify risk indicators for pain response.
Results
After interventions, pain intensity, numerical rating scale (NRS) scores, and PMI significantly improved in all patients (p < .001). Subgroup analyses revealed that pain intensity and NRS scores were notably reduced, while PMI increased after the interventions in the responders (p < .001). Conversely, no significant changes were observed in pain intensity, NRS scores, or PMI for the nonresponders following MDT intervention. MDT interventions did not lead to improvements in BADL for either group. Patients who underwent radiotherapy exhibited a significantly higher overall response rate (ORR) compared to those without radiotherapy (100% vs 60.8%, p = .033). In univariate analysis, lower KPS scores and visceral pain showed negative associations with pain response. However, in multivariate analysis, neither maintained significance.
Conclusions
The pain MDT demonstrated remarkable improvements in clinical management and pain control. Further prospective studies are warranted to investigate predictive factors associated with pain treatment.
目的：本研究的目的是评估多学科团队（MDT）治疗晚期癌症患者癌症相关疼痛的疗效和影响因素。方法：回顾性分析2018年11月至2023年12月接受MDT疼痛管理的患者。在基线和/或MDT干预2周后评估疼痛强度、疼痛管理指数（PMI）、疼痛反应和Barthel日常生活活动指数（BADL）。进行单因素和多因素logistic分析以确定疼痛反应的风险指标。结果：干预后，所有患者的疼痛强度、数值评定量表（NRS）评分和PMI均显著改善（p < 0.001）。亚组分析显示，干预后疼痛强度和NRS评分显著降低，而PMI升高（p < 0.001）。相反，在MDT干预后，无反应者的疼痛强度、NRS评分或PMI没有明显变化。MDT干预没有导致两组患者BADL的改善。接受放疗的患者总体缓解率（ORR）明显高于未接受放疗的患者（100% vs 60.8%, p = 0.033）。在单变量分析中，较低的KPS评分和内脏疼痛与疼痛反应呈负相关。然而，在多变量分析中，两者都没有保持显著性。结论：疼痛MDT在临床管理和疼痛控制方面有显著改善。进一步的前瞻性研究需要调查与疼痛治疗相关的预测因素。
期刊介绍：
This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing. Original and review articles from experts in the field offer key insights in the areas of clinical practice, advocacy, education, administration, and research. Additional features include practice guidelines and pharmacology updates.
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