Pain and Quality of Life of Cancer Patients: A Multi-Center Study in Thailand
Somboon Thienthong MD*, Nutjaree Pratheepawanit PhD**, Chulaporn Limwattananon PhD**, Savitree Maoleekoonpairoj MD***, Prasert Lertsanguansinchai MD****, Laksamee Chanvej MD*****
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen ** Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen *** Medical Oncology Unit, Department of Medicine, Pramongkutklao Hospital **** Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University ***** Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla
Objective : To identify the association between Quality Of Life (QOL) and pain intensity, and the magnitude of
change of pain scores that have a clinically significant impact on patients’ QOL.
Designs: Multi-center, prospective cohort study.
Materials and Methods : Patients suffering from cancer pain were recruited from seven university hospitals and
three tertiary care centers in Thailand. The FACT-G and the Brief Pain Inventory were used to assess QOL and
cancer pain severity, respectively, at study entry and at two-week follow-up.
Results : Five-hundred-and-twenty patients were recruited with a mean age of 52. The majority (76%) reported
two sites of pain with 80% being treated at either step 2 or 3 (WHO guidelines of pain management). After two
weeks, the average level of maximum pain was reduced from 6.6 to 4.8 (mean difference = -1.8, p < 0.001) and
the QOL was improved from 58.6 to 61.0 (mean difference = 2.4, p < 0.001). There was a high correlation
between the average change of pain intensity and QOL scores (rs = -0.42, p < 0.001). The results show that
changes of pain scores of at least three points (3 out of 10) were required for a minimal important difference
of FACT-G scores, indicating a significant change on patients’ QOL. Pain deterioration had slightly more
impact on QOL than pain improvement. A 3-point pain deterioration impaired QOL 10.3 points while 3-point
reduction increased QOL only 7.6 points.
Conclusion : The present findings suggest the importance of pain management. The change of pain scores of at
least three points (out of 10 points) had statistical and clinical significance to patients’ QOL.
Keywords : Cancer, Pain, Quality of life
