An intriguing study published in The Journal of Pain looked at the association between inadequately treated breakthrough pain experienced by cancer patients and the subsequent cost of their medical care.

Dr. Barry Fortner of the West Cancer Clinic in Memphis, Tenn. and colleagues commissioned a survey of cancer patients to determine their levels of breakthrough pain and subsequent rates of hospitalization. Out of 1,000 patients surveyed, they compared 160 who experienced flares of pain between scheduled doses of analgesic pain medication with 89 patients who did not experience such breakthrough pain between taking their scheduled pain medications.

The patients who experienced breakthrough pain averaged 1.0 hospitalizations per year, with each hospital stay lasting a mean of 7.1 days. The patients whose pain remained under control were hospitalized an average of 0.4 times per year for an average of 4.1 days per stay.

The researchers also noted that the patients with inadequately controlled pain experienced significantly more emergency department visits and more pain-related physician visits compared to the other patients.

Fortner's team calculated that hospitalizations for the patients who experienced breakthrough pain cost $1.7 million annually, compared to $192,000 annually for the patients whose pain was under control.

They concluded that many nurses and physicians do not adequately assess and manage the pain experienced by their cancer patients. Not only does this result in unnecessary discomfort for the patients, they contend, but it significantly adds to the overall medical costs for their treatment.

SOURCE:
The Journal of Pain, February 2002; 3:38-44