Frequency and severity of pain in hospitalized cancer patients at a tertiary cancer center.

Abstract

103 Background: Recent regulations in response to the opioid crisis has presented unforeseen challenges in treating cancer patients with pain, such as frequent opioid shortages and clinicians moving away from prescribing opioids. This is especially concerning in cancer hospitals where a significant proportion of patients experience pain. Understanding the current frequency and severity of pain in hospitalized cancer patients are key hospital quality indicators, and will help in directing appropriate pain initiatives and resources. We aimed to determine the frequency, severity and changes in pain severity experienced by hospitalized cancer patients. Methods: The institutional electronic database was used to extrapolate pain scores for all cancer patients discharged over one year. The proportion of hospital-days with pain overall, on admission, and discharge is reported. A severe-pain day was a hospital-day with ≥ 1 severe pain score. A moderate-pain day was a non-severe pain day with ≥ 1 moderate pain score. Results: A total of 17097 unique patients accounted for 30056 hospital-days. Overall, the proportion of severe-, moderate-, mild-, and no pain-days was 29%, 23%, 10%, and 37% respectively. The monthly pain reports (Table) demonstrates no significant difference in pain frequency or severity over time. As compared to the first hospital-day, the proportion of severe pain days on discharge decreased from 33% to 16% (p <0.01) (Medical service 28% to 16%; Pediatrics 12% to 6%, Surgical 45% to 17%). Moderate- to-severe pain days decreased from 54% to 39% (p<0.01). Conclusions: A significant proportion of hospitalized cancer patients experience moderate-to-severe pain. Comprehensive assessment of the multiple dimensions of pain and strategies for early management are needed to reduce the number of moderate and severe pain days in the inpatient setting. [Table: see text]