Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial.

McCaffrey, N; Cheah, SL; Luckett, T; Phillips, JL; Agar, M; Davidson, PM; Boyle, F; Shaw, T; Currow, DC; Lovell, M

Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial.

McCaffrey, N Cheah, SL Luckett, T

Phillips, JL Agar, M

Davidson, PM Boyle, F Shaw, T Currow, DC Lovell, M

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Publisher:: Public Library of Science (PLoS)
Publication Type:: Journal Article
Citation:: PLoS One, 2023, 18, (2), pp. e0282465
Issue Date:: 2023

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Field	Value	Language
dc.contributor.author	McCaffrey, N
dc.contributor.author	Cheah, SL
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409
dc.contributor.author	Phillips, JL
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119
dc.contributor.author	Davidson, PM
dc.contributor.author	Boyle, F
dc.contributor.author	Shaw, T
dc.contributor.author	Currow, DC
dc.contributor.author	Lovell, M https://orcid.org/0000-0002-1407-2748
dc.contributor.editor	Montazeri, A
dc.date.accessioned	2023-09-05T05:53:05Z
dc.date.available	2023-02-16
dc.date.available	2023-09-05T05:53:05Z
dc.date.issued	2023
dc.identifier.citation	PLoS One, 2023, 18, (2), pp. e0282465
dc.identifier.issn	1932-6203
dc.identifier.issn	1932-6203
dc.identifier.uri	http://hdl.handle.net/10453/171919
dc.description.abstract	BACKGROUND: About 70% of patients with advanced cancer experience pain. Few studies have investigated the use of healthcare in this population and the relationship between pain intensity and costs. METHODS: Adults with advanced cancer and scored worst pain ≥ 2/10 on a numeric rating scale (NRS) were recruited from 6 Australian oncology/palliative care outpatient services to the Stop Cancer PAIN trial (08/15-06/19). Out-of-hospital, publicly funded services, prescriptions and costs were estimated for the three months before pain screening. Descriptive statistics summarize the clinico-demographic variables, health services and costs, treatments and pain scores. Relationships with costs were explored using Spearman correlations, Mann-Whitney U and Kruskal-Wallis tests, and a gamma log-link generalized linear model. RESULTS: Overall, 212 participants had median worst pain scores of five (inter-quartile range 4). The most frequently prescribed medications were opioids (60.1%) and peptic ulcer/gastro-oesophageal reflux disease (GORD) drugs (51.6%). The total average healthcare cost in the three months before the census date was A$6,742 (95% CI $5,637, $7,847), approximately $27,000 annually. Men had higher mean healthcare costs than women, adjusting for age, cancer type and pain levels (men $7,872, women $4,493, p<0.01) and higher expenditure on prescriptions (men $5,559, women $2,034, p<0.01). CONCLUSIONS: In this population with pain and cancer, there was no clear relationship between healthcare costs and pain severity. These treatment patterns requiring further exploration including the prevalence of peptic ulcer/GORD drugs, and lipid lowering agents and the higher healthcare costs for men. TRIAL REGISTRATION: ACTRN12615000064505. World Health Organisation unique trial number U1111-1164-4649. Registered 23 January 2015.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Public Library of Science (PLoS)
dc.relation	National Breast Cancer FoundationNT-14-008
dc.relation.ispartof	PLoS One
dc.relation.isbasedon	10.1371/journal.pone.0282465
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	General Science & Technology
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Australia
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Gastroesophageal Reflux
dc.subject.mesh	Hospitals
dc.subject.mesh	Neoplasms
dc.subject.mesh	Outpatients
dc.subject.mesh	Pain
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Gastroesophageal Reflux
dc.subject.mesh	Pain
dc.subject.mesh	Adult
dc.subject.mesh	Outpatients
dc.subject.mesh	Hospitals
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Adult
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Australia
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Gastroesophageal Reflux
dc.subject.mesh	Hospitals
dc.subject.mesh	Neoplasms
dc.subject.mesh	Outpatients
dc.subject.mesh	Pain
dc.subject.mesh	Patient Acceptance of Health Care
dc.title	Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial.
dc.type	Journal Article
utslib.citation.volume	18
utslib.location.activity	United States
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	open_access	*
dc.date.updated	2023-09-05T05:53:02Z
pubs.issue	2
pubs.publication-status	Published online
pubs.volume	18
utslib.citation.issue	2

Abstract:

BACKGROUND: About 70% of patients with advanced cancer experience pain. Few studies have investigated the use of healthcare in this population and the relationship between pain intensity and costs. METHODS: Adults with advanced cancer and scored worst pain ≥ 2/10 on a numeric rating scale (NRS) were recruited from 6 Australian oncology/palliative care outpatient services to the Stop Cancer PAIN trial (08/15-06/19). Out-of-hospital, publicly funded services, prescriptions and costs were estimated for the three months before pain screening. Descriptive statistics summarize the clinico-demographic variables, health services and costs, treatments and pain scores. Relationships with costs were explored using Spearman correlations, Mann-Whitney U and Kruskal-Wallis tests, and a gamma log-link generalized linear model. RESULTS: Overall, 212 participants had median worst pain scores of five (inter-quartile range 4). The most frequently prescribed medications were opioids (60.1%) and peptic ulcer/gastro-oesophageal reflux disease (GORD) drugs (51.6%). The total average healthcare cost in the three months before the census date was A$6,742 (95% CI $5,637, $7,847), approximately $27,000 annually. Men had higher mean healthcare costs than women, adjusting for age, cancer type and pain levels (men $7,872, women $4,493, p<0.01) and higher expenditure on prescriptions (men $5,559, women $2,034, p<0.01). CONCLUSIONS: In this population with pain and cancer, there was no clear relationship between healthcare costs and pain severity. These treatment patterns requiring further exploration including the prevalence of peptic ulcer/GORD drugs, and lipid lowering agents and the higher healthcare costs for men. TRIAL REGISTRATION: ACTRN12615000064505. World Health Organisation unique trial number U1111-1164-4649. Registered 23 January 2015.

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