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Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings

Cancer-related pain constitutes a dominant reason for admission to emergency services, and a significant patient and healthcare challenge. Evidence points to the rising prevalence of opioid misuse in this patient group. We sought to compare drug delivery in an oncology-dedicated emergency department...

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Autores principales: Turgeman, Ilit, Campisi-Pinto, Salvatore, Habiballah, Maher, Bar-Sela, Gil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320698/
https://www.ncbi.nlm.nih.gov/pubmed/35890103
http://dx.doi.org/10.3390/ph15070805
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author Turgeman, Ilit
Campisi-Pinto, Salvatore
Habiballah, Maher
Bar-Sela, Gil
author_facet Turgeman, Ilit
Campisi-Pinto, Salvatore
Habiballah, Maher
Bar-Sela, Gil
author_sort Turgeman, Ilit
collection PubMed
description Cancer-related pain constitutes a dominant reason for admission to emergency services, and a significant patient and healthcare challenge. Evidence points to the rising prevalence of opioid misuse in this patient group. We sought to compare drug delivery in an oncology-dedicated emergency department (OED) and a general emergency department (GED) within the same hospital. As such, we obtained patient and drug-related data for OED and GED during a designated three-month period, and compared them using Fisher’s exact test, chi-square tests and the Mann-Whitney test. In total, 584 patients had 922 visits to emergency services (OED n = 479; GED n = 443), and were given 1478 drugs (OED n = 557; GED n = 921). Pain was a prominent chief complaint among visitors to the OED (17%) and GED (21%). Approximately a fifth of all drugs used were analgesics (OED—18.5%; GED—20.4%), however, in the GED, 51.6% (n = 97) were used for non-pain-related admissions, compared with 33.0% (n = 34) in OED. Opioid usage significantly differed between emergency settings. The GED administered three times as many intravenous opioids (p <0.001), a narrower spectrum of oral and intravenous drugs (p = 0.003) and no rapid-acting opioids, significantly fewer pain adjuvants (10.9% versus 18.7%, p < 0.001), and, finally, non-guideline-recommended drugs for pain, such as meperidine and benzodiazepines. Taken together, compared with the GED, the management of cancer-related pain in the OED was more personalized, and characterized by fewer intravenous opioids, enhanced diversity in drug type, route and method of delivery. Efforts should be directed toward reduction of disparities in the treatment of cancer pain in emergency settings.
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spelling pubmed-93206982022-07-27 Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings Turgeman, Ilit Campisi-Pinto, Salvatore Habiballah, Maher Bar-Sela, Gil Pharmaceuticals (Basel) Article Cancer-related pain constitutes a dominant reason for admission to emergency services, and a significant patient and healthcare challenge. Evidence points to the rising prevalence of opioid misuse in this patient group. We sought to compare drug delivery in an oncology-dedicated emergency department (OED) and a general emergency department (GED) within the same hospital. As such, we obtained patient and drug-related data for OED and GED during a designated three-month period, and compared them using Fisher’s exact test, chi-square tests and the Mann-Whitney test. In total, 584 patients had 922 visits to emergency services (OED n = 479; GED n = 443), and were given 1478 drugs (OED n = 557; GED n = 921). Pain was a prominent chief complaint among visitors to the OED (17%) and GED (21%). Approximately a fifth of all drugs used were analgesics (OED—18.5%; GED—20.4%), however, in the GED, 51.6% (n = 97) were used for non-pain-related admissions, compared with 33.0% (n = 34) in OED. Opioid usage significantly differed between emergency settings. The GED administered three times as many intravenous opioids (p <0.001), a narrower spectrum of oral and intravenous drugs (p = 0.003) and no rapid-acting opioids, significantly fewer pain adjuvants (10.9% versus 18.7%, p < 0.001), and, finally, non-guideline-recommended drugs for pain, such as meperidine and benzodiazepines. Taken together, compared with the GED, the management of cancer-related pain in the OED was more personalized, and characterized by fewer intravenous opioids, enhanced diversity in drug type, route and method of delivery. Efforts should be directed toward reduction of disparities in the treatment of cancer pain in emergency settings. MDPI 2022-06-28 /pmc/articles/PMC9320698/ /pubmed/35890103 http://dx.doi.org/10.3390/ph15070805 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Turgeman, Ilit
Campisi-Pinto, Salvatore
Habiballah, Maher
Bar-Sela, Gil
Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title_full Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title_fullStr Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title_full_unstemmed Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title_short Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings
title_sort approach to cancer pain management in emergency departments: comparison of general and oncology based settings
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320698/
https://www.ncbi.nlm.nih.gov/pubmed/35890103
http://dx.doi.org/10.3390/ph15070805
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