A secondary analysis: the impact of pre-existing chronic pain among patients with cancer presenting to the emergency department with acute pain
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Author(s)
Beck, Meghan
Schreiber, Kristin L.
Wilson, Jenna M.
Flowers, K. M.
Edwards, Robert R.
Chai, Peter R.
Azizoddin, Desiree R.
Date Issued
January 25, 2024
Journal
Supportive Care in Cancer
Publisher
Springer Berlin Heidelberg
Citation
Beck, M., Schreiber, K.L., Wilson, J.M. et al. A secondary analysis: the impact of pre-existing chronic pain among patients with cancer presenting to the emergency department with acute pain. Support Care Cancer 32, 129 (2024).
Version
Author's final manuscript
Abstract
Purpose Patients with cancer may experience pain from cancer itself or its treatment. Additionally, chronic pain (CP) predating a patient’s cancer diagnosis may make the etiology of pain less clear and the management of pain more complex. In this brief report, we investigated differences in biopsychosocial characteristics, pain severity, and opioid consumption, comparing groups of cancer patients with and without a history of CP who presented to the emergency department (ED) with a complaint of cancer-related pain. Methods This secondary analysis of a prospective cohort study included patients with cancer who presented to the ED with a complaint of pain (≥ 4/10). Sociodemographic, clinical, psychological, and pain characteristics were assessed in the ED and subsequent hospitalization. Mann-Whitney U-, T-, and Chi-square tests were used to compare differences between patients with and without pre-existing CP before cancer. Results Patients with pre-existing CP had lower income (p = 0.21) and less formal education (p = 0.25) and were more likely to have a diagnosis of depression or substance use disorder (p < 0.01). Patients with pre-existing CP reported significantly greater pain severity in the ED and during hospitalization compared to those without pre-existing CP (p < 0.05), despite receiving greater amounts of opioid analgesics (p = 0.036). Conclusion Identifying a history of pre-existing CP during intake may help identify patients with cancer with difficult to manage pain, who may particularly benefit from multimodal interventions and supportive care. In addition, referral of these patients for the management of co-occurring pain disorders may help decrease the usage of the ED for undertreated pain.
MIT Department
Koch Institute for Integrative Cancer Research at MIT
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Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
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DOI of Published Version
https://doi.org/10.1007/s00520-024-08314-8
