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Predictors of cancer-related pain improvement over time

机译：随着时间的流逝，与癌症相关的疼痛改善的预测指标

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Objective: To determine the predictors of pain improvement among patients being treated for cancer-related pain over 12 months. Methods: A secondary analysis of the telephone care Indiana Cancer Pain and Depression trial was performed. Patients (n = 274) were interviewed at baseline and after 1, 3, 6, and 12 months. Pain improvement outcomes included both a continuous measure (Brief Pain Inventory score) and a categorical measure (pain improved versus pain not improved). Predictor variables included change in depression, age, sex, race, marital status, socioeconomic disadvantage, medical comorbidity, type of cancer, and phase of cancer. Multivariable repeated measures were conducted, adjusting for intervention group assignment, baseline pain severity, and time in months since baseline assessment. Results: Factors significantly predicting both continuous and categorical pain improvement included participating in the intervention group (β =-0.92, p < .001, odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.65-3.89), greater improvement in depression (β =-0.31, p = .003, OR = 1.84, 95% CI = 1.35-2.51), higher socioeconomic status (Socioeconomic Disadvantage index; β = 0.25, p = .034; OR = 0.73, 95% CI = 0.56-0.94), and fewer comorbid conditions (β = 0.20, p = .002; OR = 0.84, 95% CI = 0.73-0.96). Patients with more severe pain at baseline or with recurrent or progressive cancer were less likely to experience continuous or categorical pain improvement, respectively. Conclusions: Effective management of depression and comorbid conditions along with improvement of social services could be critical components of a comprehensive pain management. Patients with more severe pain or with recurrent or progressive cancers may require closer monitoring and adequate treatment of pain. Trial Registration: clinicaltrials.gov Identifier: NCT00313573.
机译：目的：确定在12个月内接受癌症相关疼痛治疗的患者中疼痛改善的预测指标。方法：对印第安纳州癌症疼痛和抑郁症的电话护理进行了二次分析。在基线以及1、3、6和12个月后对患者（n = 274）进行了访谈。疼痛改善结局包括连续测量（简短疼痛库存量表评分）和分类测量（疼痛改善与疼痛未改善）。预测变量包括抑郁症，年龄，性别，种族，婚姻状况，社会经济劣势，医学合并症，癌症类型和癌症阶段的变化。进行了多变量重复测量，调整了干预组分配，基线疼痛严重程度和自基线评估以来的时间（以月为单位）。结果：参与干预组的患者能够显着预测持续和绝对疼痛改善的因素（β= -0.92，p <.001，优势比[OR] = 2.53，95％置信区间[CI] = 1.65-3.89），更大抑郁症改善（β= -0.31，p = .003，OR = 1.84，95％CI = 1.35-2.51），较高的社会经济地位（社会经济弱势指数;β= 0.25，p = .034; OR = 0.73，95％ CI = 0.56-0.94）和更少的合并症条件（β= 0.20，p = .002; OR = 0.84，95％CI = 0.73-0.96）。基线时疼痛更严重或复发或进行性癌症的患者分别经历持续性或分类性疼痛改善的可能性较小。结论：有效的抑郁症和合并症治疗以及社会服务的改善可能是全面疼痛治疗的关键组成部分。疼痛更严重或患有复发性或进行性癌症的患者可能需要更严格的监测和适当的疼痛治疗。试用注册：clinicaltrials.gov标识符：NCT00313573。

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