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Patient-reported outcomes in light of supportive medications in treatment-naïve lung cancer patients.
Supportive Care in Cancer ( IF 3.1 ) Pub Date : 2019-07-23 , DOI: 10.1007/s00520-019-05004-8
Johnny M Hoang 1 , Navneet Upadhyay 2 , Dozie N Dike 1 , Jaekyu Lee 1 , Michael L Johnson 2 , Charles S Cleeland 3 , Tito Mendoza 3 , Hua Chen 2 , Meghana V Trivedi 1
Affiliation  

PURPOSE The impact of supportive medications on patient-reported outcomes (PROs) has not been systematically evaluated. We describe the supportive medications used by treatment-naïve lung cancer patients and assess their association with PROs from MD Anderson Symptom Inventory (MDASI). METHODS Treatment-naïve lung cancer patients who completed PROs from MDASI at the initial visit to MD Anderson Cancer Center were included. Medications from the initial visit were abstracted from the electronic medical records system and categorized into therapeutic classes based on U.S. Pharmacopeia v7.0. A chi-square or Mann-Whitney U test was conducted as appropriate. RESULTS Among 459 patients, ~ 50% took any analgesics and 25% were on opioids. One-third of patients with moderate-severe pain were not on any analgesics. Patients taking opioids had significantly worse median pain scores (6 vs. 0) compared with those not taking any analgesics (p < 0.0001). Higher proportion of patients with moderate-severe pain took opioids compared with those with mild pain (52% vs. 16%, p < 0.0001). Patients on opioids also reported significantly worse scores for five other cancer-specific core symptoms and all six symptoms rating interference with daily life. Only 15% of patients with higher composite score for depression-related symptoms were on antidepressants. However, patients taking antidepressants did not significantly differ in any individual MDASI symptom scores compared with those not on antidepressants (p = 0.4858). CONCLUSIONS Our results suggest a need for better screening for pain and depression and optimization of pain management in treatment-naïve lung cancer patients since their poor functional status may result in suboptimal cancer therapy.

中文翻译:

在未接受治疗的肺癌患者中,根据支持药物对患者的结果进行了报告。

目的尚未对支持药物对患者报告的结局(PROs)的影响进行系统评估。我们描述了未经治疗的肺癌患者使用的支持药物,并评估了它们与MD安德森症状清单(MDASI)的PRO的关联。方法包括首次在MD安德森癌症中心就诊时从MDASI完成PRO的未接受过治疗的肺癌患者。首次就诊的药物是从电子病历系统中提取的,并根据美国药典v7.0分为治疗类。进行卡方检验或Mann-Whitney U检验。结果在459名患者中,约有50%接受了任何镇痛药,而25%的患者使用了阿片类药物。三分之一的中度重度疼痛患者未使用任何镇痛药。与不使用任何镇痛药的患者相比,服用阿片类药物的患者的中位疼痛评分(6 vs. 0)明显更差(p <0.0001)。与轻度疼痛患者相比,中度重度疼痛患者服用阿片类药物的比例更高(52%比16%,p <0.0001)。使用阿片类药物的患者还报告了其他五种癌症特有的核心症状的评分明显较差,并且所有六种症状均对日常生活造成了干扰。在抑郁相关症状综合评分较高的患者中,只有15%使用抗抑郁药。但是,与未服用抗抑郁药的患者相比,服用抗抑郁药的患者的任何MDASI症状评分均无显着差异(p = 0.4858)。
更新日期:2020-02-23
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