• Anne Kari Knudsen, Cinzia Brunelli, Stein Kaasa, Giovanni Apolone, Oscar Corli, Mauro Montanari, Robin Fainsinger, Nina Aass, Peter Fayers, Augusto Caraceni, Pål Klepstad, European Palliative Care Research Collaborative, and European Pharmacogenetic Study.
• European Palliative Care Research Centre, Faculty of Medicine, NTNU, NO-7006 Trondheim, Norway. anne.k.knudsen@ntnu.no
• Eur J Pain. 2011 Mar 1;15(3):320-7.

BackgroundThis study is part of a research program to reach consensus on an international cancer pain classification system. A confirmative and explorative approach was applied to investigate which of the variables identified in the literature, by experts and patients that are associated with pain.MethodsData from an international, multicentre, cross-sectional study of cancer patients treated with opioids were investigated. Dependent variables were: average pain, worst pain, and pain relief (11-point Numerical Rating Scales). Forty-six independent variables were chosen based upon previous studies. Bivariate analyses identified independent variables associated with at least one of the dependent ones; 21 were included in multivariate linear regression analyses.ResultsTwo thousand two hundred and seventy-eight patients were investigated; 52% males, mean age 62 years, mean Karnofsky Performance Status 59%, mean daily opioid oral equivalent dose 341 mg. Fifty-eight percent had breakthrough pain. Mean pain scores were: average pain 3.5, worst pain 5.3 and pain relief 74%. Variables most strongly associated with these three dependent variables were: breakthrough pain, psychological distress, sleep, and opioid dose.ConclusionsBreakthrough pain and psychological distress were confirmed as key variables of a future classification system. Candidate variables were: sleep, opioid dose, pain mechanism, use of non-opioids, pain localisation, cancer diagnosis, location of metastases, and addiction.Copyright © 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

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