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01-04-2020 | Analgesics in Dentistry | Original Article

Pain management index (PMI)—does it reflect cancer patients’ wish for focus on pain?

Authors: Morten Thronæs, Trude Rakel Balstad, Cinzia Brunelli, Erik Torbjørn Løhre, Pål Klepstad, Ola Magne Vagnildhaug, Stein Kaasa, Anne Kari Knudsen, Tora Skeidsvoll Solheim

Published in: Supportive Care in Cancer | Issue 4/2020

Abstract

Background

The pain management index (PMI) was developed to combine information about the prescribed analgesics and the self-reported pain intensity in order to assess physicians’ response to patients’ pain. However, PMI has been used to explore undertreatment of cancer pain. The present study explores prevalence of negative PMI and its associations to clinical variables, including the patient-perceived wish for more attention to pain.

Methods

A single-center, cross-sectional, observational study of cancer patients was conducted. Data on demographics and clinical variables, as well as patient-perceived wish for more attention to pain, were registered. PMI was calculated. Negative PMI indicates that the analgesics prescribed might not be appropriate to the pain intensity reported by the patient, and associations to negative PMI were explored by logistic regression models.

Results

One hundred eighty-seven patients were included, 53% had a negative PMI score. Negative PMI scores were more frequent among patients with breast cancer (OR 4.2, 95% CI 1.3, 13.5), in a follow-up setting (OR 12.1, 95% CI 1.4, 101.4), and were inversely associated to low performance status (OR 0.14, 95% CI 0.03, 0.65). Twenty-two percent of patients with negative PMI scores reported that they wanted more focus on pain management, versus 13% among patients with a non-negative PMI score; the difference was not statistically significant.

Conclusion

A high prevalence of negative PMI was observed, but only 1/5 of patients with a negative PMI wanted more attention to pain by their physician. Our findings challenge the use of PMI as a measure of undertreatment of cancer pain.

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Title: Pain management index (PMI)—does it reflect cancer patients’ wish for focus on pain?
Authors: Morten Thronæs
Trude Rakel Balstad
Cinzia Brunelli
Erik Torbjørn Løhre
Pål Klepstad
Ola Magne Vagnildhaug
Stein Kaasa
Anne Kari Knudsen
Tora Skeidsvoll Solheim
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keyword: Analgesics in Dentistry
Published in: Supportive Care in Cancer / Issue 4/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-04981-0

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