No study has so far addressed whether differences do exist in the management of cancer pain between patients receiving usual care by primary specialists and those receiving early palliative/supportive intervention.
Patients and methods
A multicentre cross-sectional study in 32 Italian Hospitals has included 1450 patients, receiving analgesic therapy for cancer pain: 602 with access to primary specialist alone (standard care, SC) and 848 with early access to a palliative/supportive care (ePSC) team, concomitant with primary oncology care.
Results
Statistically significant differences in the analgesic drug administration according to care model have been evident: non-opioids were more frequently used in SC (9.5 % versus 2 % ; P < 0.001), while strong opioids in ePSC group (80 % versus 63 % ; P < 0.001). The number of patients with severe pain was lower in ePSC compared with SC group (31 % versus 17 % ; P < 0.001). Results of multivariate analysis have shown that ePSC integrated with primary oncologic care (relative risk 0.69; 95 % confidence interval 0.48–0.99; P = 0.045) was an independent factor associated with a 31 % reduced risk of suffering from severe pain.
Conclusions
An ePSC team provides the most effective standard of analgesic therapy for cancer pain. A randomized clinical trial is needed to confirm these findings.
