6533b831fe1ef96bd1298e21

RESEARCH PRODUCT

Documentation of Severe Pain, Opioid Doses, and Opioid-Related Side Effects in Outpatients with Cancer

subject

description

Pain severity, prescribed opioids including "rescue" medication for breakthrough pain, bowel movements, and laxative prescription were evaluated in 54 cancer patients treated in an outpatient department devoted to hematology and oncology during 1996. Median number of visits per patient was 5.5 (range 1-48), and median duration of patient care during opioid therapy was 44.5 days (range 1-363). Pain severity and opioid dose were not documented, or documented in less than 25% of visits, in 62.9% and 48.2%, respectively. Rescue doses for breakthrough pain, laxative prescription and bowel movements were never mentioned in 70.4%, 68.5%, and 87% respectively, of all patient charts. Only 3 of 12 physicians documented pain severity in more than 15% of visits, and opioid dose was recorded in more than 30% of all visits only by four physicians. Rescue doses for breakthrough pain, laxative prescription, and bowel movements were never or only scarcely documented by all physicians. Pain measurement using a visual analog scale was recorded by one physician. Our data show inadequate documentation of important aspects of cancer pain in a large outpatient department of hematology and oncology. These deficiencies may have a major negative impact on the quality of cancer pain treatment.