Patient-reported outcomes in light of supportive medications in treatment-naïve lung cancer patients

Johnny M. Hoang, Navneet Upadhyay, Dozie N. Dike, Jaekyu Lee, Michael L. Johnson, Charles S. Cleeland, Tito Mendoza, Hua Chen, Meghana V. Trivedi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: The impact of supportive medications on patient-reported outcomes (PROs) has not been systematically evaluated. We describe the supportive medications used by treatment-naïve lung cancer patients and assess their association with PROs from MD Anderson Symptom Inventory (MDASI). Methods: Treatment-naïve lung cancer patients who completed PROs from MDASI at the initial visit to MD Anderson Cancer Center were included. Medications from the initial visit were abstracted from the electronic medical records system and categorized into therapeutic classes based on U.S. Pharmacopeia v7.0. A chi-square or Mann-Whitney U test was conducted as appropriate. Results: Among 459 patients, ~ 50% took any analgesics and 25% were on opioids. One-third of patients with moderate-severe pain were not on any analgesics. Patients taking opioids had significantly worse median pain scores (6 vs. 0) compared with those not taking any analgesics (p < 0.0001). Higher proportion of patients with moderate-severe pain took opioids compared with those with mild pain (52% vs. 16%, p < 0.0001). Patients on opioids also reported significantly worse scores for five other cancer-specific core symptoms and all six symptoms rating interference with daily life. Only 15% of patients with higher composite score for depression-related symptoms were on antidepressants. However, patients taking antidepressants did not significantly differ in any individual MDASI symptom scores compared with those not on antidepressants (p = 0.4858). Conclusions: Our results suggest a need for better screening for pain and depression and optimization of pain management in treatment-naïve lung cancer patients since their poor functional status may result in suboptimal cancer therapy.

Original languageEnglish (US)
Pages (from-to)1809-1816
Number of pages8
JournalSupportive Care in Cancer
Volume28
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • Antidepressants
  • Lung cancer patients
  • Pain management
  • Patient-reported outcomes
  • Supportive care medications

ASJC Scopus subject areas

  • Oncology

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