Do specialized oncology units improve the detection and management of pain?

Abstract

6084 Background: Pain is a common complaint of cancer patients and has a significant impact on quality of life. The objective of this study was to compare pain management for cancer patients admitted to dedicated oncology vs. general medicine/surgery units. Methods: Design: Secondary analysis of data obtained from a controlled clinical trial evaluating a series of interventions to improve pain outcomes conducted from 4/2002–2/2003. Setting: 1,171 bed hospital. Patients: 445 hospitalized adult oncology patients; 239 patients admitted to a specialized oncology unit, 206 patients admitted to general medicine/surgery units. Main outcome measures: Pain assessment and severity, analgesic prescribing. Analysis: T tests and chi square were used to compare patient characteristics. Hierarchical linear modeling (HLM) was used to explore the effect of a specialized oncology unit on pain assessment, severity, and analgesic and laxative prescribing. Results: The two groups did not differ significantly in patient characteristics. Mean age was 59 years, 56% were men, 61% were white, 79% had solid tumors. In multivariate analysis, patients admitted to a specialized oncology unit had significantly less pain (mean pain score for patients on oncology unit was 1.24 vs 1.68 for non-oncology unit; parameter estimate = −0.42; p<0.01). There were no significant differences in the frequency of nursing assessment of pain, opiate prescribing, or laxative prescribing for those patients receiving opioids. Conclusion: In multivariate analysis, admission to a specialized oncology unit was associated with significantly less reported pain. These findings have implications for structuring medical units for patients at high risk for pain. No significant financial relationships to disclose.