Jason W Boland
The relationship between pain, analgesics and survival in patients with advanced cancer: a secondary data analysis of the international European palliative care cancer symptom study.
Boland, Jason W; Allgar, Victoria; Boland, Elaine G; Bennett, Mike I; Kaasa, Stein; Hjermstad, Marianne Jensen; Johnson, Miriam
Elaine G Boland
Mike I Bennett
Marianne Jensen Hjermstad
Professor Miriam Johnson Miriam.Johnson@hull.ac.uk
Opioids reduce cancer-related pain but an association with shorter survival is variably reported. Aim: To investigate the relationship between pain, analgesics, cancer and survival within the European Palliative Care Cancer Symptom (EPCCS) study to help inform clinical decision making.
Secondary analysis of the international prospective, longitudinal EPCCS study which included 1739 adults with advanced, incurable cancer receiving palliative care. In this secondary analysis, for all participants with date of death or last follow up, a multilevel Weibull survival analysis examined whether pain, analgesics, and other relevant variables are associated with time to death.
Date of death or last follow-up was available for 1404 patients (mean age 65.7 [SD:12.3];men 50%). Secondary analysis of this group showed the mean survival from baseline was 46.5 (SD:1.5) weeks (95% CI:43.6–49.3). Pain was reported by 76%; 60% were taking opioids, 51% non-opioid analgesics and 24% co-analgesics. Opioid-use was associated with decreased survival in the multivariable model (HR = 1.59 (95% CI:1.38–1.84), p
|Journal Article Type||Article|
|Journal||European Journal of Clinical Pharmacology|
|Publisher||Springer (part of Springer Nature)|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Boland, J. W., Allgar, V., Boland, E. G., Bennett, M. I., Kaasa, S., Hjermstad, M. J., & Johnson, M. (in press). The relationship between pain, analgesics and survival in patients with advanced cancer: a secondary data analysis of the international European palliative care cancer symptom study. European Journal of Clinical Pharmacology, https://doi.org/10.1007/s00228-019-02801-2|
|Keywords||Pharmacology (medical); Pharmacology; General Medicine; Neoplasms; Pain; Analgesics; Opioids; Survival|
|Additional Information||Received: 13 August 2019; Accepted: 18 November 2019; First Online: 21 December 2019; : ; : None of the authors declare any conflicts of interest.; : Central Norway Regional Health Authority (grant no. 46055100), The Cancer Foundation St Olavs Hospital, Norway, Trondheim University Hospital (grant no. 6070) and an unrestricted grant from the Helsinn group, Switzerland.|
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