Skip to main content

Table 2 Comparison between ESAS-r scores, opioid/non opioid analgesics and adjuvant medications before (D0) and after referral to Palliative Care Centre between D0 and D6

From: The pattern of change in opioid and adjuvant prescriptions for cancer pain before and after referral to a comprehensive program in the Palliative Care Center in Kuwait

 

Before

D6

Z scorea

P value*

ESAS-r pain

6(4–8)

3(0–4)

− 12.637

< 0.001

ESAS-r tiredness

2(2–5)

2(1–4)

−1.936

0.026

ESAS-r drowsiness

1(1–6)

1(1–4)

−1.223

0.111

ESAS-r nausea

2(1–7)

1(0–2)

−8.105

< 0.001

ESAS-r lack of appetite

5(2–8)

3(1–5)

−6.265

< 0.001

ESAS-r shortness of breath

2(1–6)

0(0–1)

−2.822

0.005

ESAS-r depression

3(2–6)

2(1–4)

−4.842

< 0.001

ESAS-r anxiety

6(4–9)

2(1–4)

−5.570

< 0.001

ESAS-r wellbeing

6(2–8)

4(3–6)

−8.970

< 0.001

Opioids/non-opioids analgesics number

 None

23(9.6%)

0(0%)

  

 One drug

137(57.1%)

189(78.8%)

  

 Two drugs

70(29.2%)

46(19.2%)

 

0.01

 Three drugs

8(3.3%)

5(2.1%)

  

 Four drugs

2(0.8%)

0

  

MEDD in mg/day

 Regular

60(31–93)

34(22–66)

−3.951

< 0.001

 PRN only

8(0–13)

5(2–10)

-2.271

0.027

Morphine

49(20.4%)

119(49.6%)

 

< 0.001

Oxycodone

50(20.8%)

32(13.3%)

 

< 0.001

Transdermal fentanyl patch

70(29.2%)

24(10%)

 

< 0.001

Tramadol

69(28.8%)

71(29.6%)

 

< 0.001

Paracetamol/NSAIDs Adjuvants

65(27.3%)

40(16.7%)

 

0.001

 NON

147(61.2%)

38(15.8%)

  

 One drug

67(27.9%)

76(31.7%)

  

 Two drugs

15(6.2%)

62(25.8%)

−9.638

< 0.001

 Three drugs

9(3.8%)

45(18.8%)

  

 Four drugs

2(0.8%)

19(7.9%)

  

Gabapentinoids

57(23.75%)

79(32.9%)

 

< 0.001

 Gabapentin

36 (15%)

57(23.75%)

  

600(300–900)

900(300–1200)

−2.035

0.04

 Pregabalin

21(8.75%)

22 (9.15%)

  

300(75–300)

300(150–450)

−0.577

0.564

Dexamethasone

13(5.4%)

20(8.3%)

 

< 0.001

8(8–16)

8(4–13)

−1.138

0.186

Antidepressant drugs n(%) Median (IQR) mg/day

 Amitriptyline

14(5.8%)

44(18.3%)

 

0.002

25(10–25)

50(35–100)

−1.931

0.042

 Other ADD

15(6.2%)

34(14.1%)

 

< 0.001

 Duloxetine

30(30–60)

60(30–60)

−.587

0.564

 Escitalopram

5(5–10)

10(10–10)

−2.333

0.016

 Sertraline

0.0

50(50–50)

−15.765

< 0.001

 Mirtazapine

15(7.5–15)

15(15–30)

−1.783

0.085

Benzodiazepinesb

10(4.2%)

27(11.2%)

 

< 0.001

Antipsychotic drugsc

8(3.3%)

11(4.6%)

 

< 0.001

  1. ESAS-r: Edmonton symptoms assessment scale-revised, ESAS Items represented in median and interquartile range
  2. MEDD: morphine equivalent daily dose
  3. n(%):represents patients ‘number and their percent using different opioids and adjuvant medications
  4. Quantitative variables represented as median (IQR)for ESAS-r scores, drug doses
  5. aZ score was for Wilcoxon Signed Ranks Test for comparing 2 groups of quantitative data
  6. bBenzodiazepines: Midazolam, Lorazepam, Alprazolam, Bromazepam
  7. cAntipsychotic drugs: Haloperidol, Quetiapine, Olanzapine, Chlorpromazine
  8. *P value was considered significant if < 0.05
Back to article page

BMC Palliative Care

ISSN: 1472-684X

Contact us