HIGHLIGHTS FROM THE 11TH EAPC WORLD RESEARCH CONGRESS ONLINE 2020
We are delighted to invite Johan Haumann to tell us more about his winning paper that was awarded ‘Best European Paper published in 2019’ by ‘Journal of Palliative Medicine’ and the European Association for Palliative. And there is free access to the full-text article until 15 November 2020…
We are honoured that our manuscript, ‘The association between patient characteristics and opioid treatment response in neuropathic and nociceptive pain due to cancer’ has won the award for ‘Best European Paper Published in Journal of Palliative Medicine in 2019’. The award was presented at the 11th World Research Congress Online of the European Association for Palliative Care on 9 October 2020.
In our clinical work at the Department of Anaesthesiology and Pain Management at OLVG and MUMC+ in The Netherlands we notice that some patients with pain respond very well to opioids, whereas other patients need many alterations to their pain medication. It is clear that a patient that needs many opioid adjustments suffers from pain or side effects more than we would wish. Every clinician wants to be able to treat the pain as well as possible, and would like to be able to explain to the patient the chance for clinically relevant pain reduction.
In this manuscript, we describe how we explored predictors for clinically relevant pain reduction in a patient population (n=134) with neuropathic or nociceptive pain due to head-and-neck cancer. Multiple regression analyses of many patient and treatment characteristics showed a correlation between treatment response (defined as 50 per cent pain reduction or more after one week) and the age of the patient (younger patients responded better), the duration of pain (longer duration of pain in months responded better), the type of pain (neuropathic pain responded better than nociceptive pain) and the opioid prescribed (methadone responded better than fentanyl). Other characteristics were not correlated with opioid therapy success. With these four predictors we created a predictive model that predicts the chance of 50 per cent pain reduction with an area under the curve of 0.81.
This award shows that there is a need for a good predictive model for cancer patients with pain. As mentioned in the manuscript, this is just a first step in the development of a robust model. The data we used for the development of this model is from two patient populations; one with a neuropathic pain component as measured with the DN4 questionnaire (n=52); one with nociceptive pain due to radiation induced mucositis (n=82). It is very possible that the type and source of the pain in these patients have an important impact on opioid therapy success. Although the internal validation shows that this model works well in our patient population with head-and-neck cancer, we would like to validate this model in other patient populations. We hope that external validation improves this model and leads to a model that we can use for patients with several types of pain and several opioids.
Clinicians and researchers – can you help us with more data?
In order to validate this model we need data from different patients treated with opioids for pain. Before the congress some researchers had already agreed to share their data with us, but the more data, the better the model. We had hoped to get in contact with more researchers at the congress, but due to COVID-19 the in-person congress in Palermo was cancelled. The online congress was excellent, but the online format made it less easy for us to get in contact with these researchers. Therefore, we would like to ask researchers or clinicians with good data to get in contact with us to start collaboration to further validate this model. If you have questions, feel free to email me as well.
Download a free copy of the full-text article from ‘Journal of Palliative Medicine’ until 15 November…
This post relates to the longer article, ‘The Association between Patient Characteristics and Opioid Treatment Response in Neuropathic and Nociceptive Pain due to Cancer’ by Haumann J, van Kuijk SMJ, Joosten EA, van den Beuken-van Everdingen MHJ. J Palliat Med. 2019 Feb; 22 (2):157-163. doi: 10.1089/jpm.2018.0281. Epub 2018 Oct 25.
EAPC members are eligible for a substantial discount on a personal online subscription to Journal of Palliative Medicine. More information here.
- Contact Dr Johan Haumann by email.
- View all the content of the 11th EAPC World Research Congress until 31 January 2021. Login here https://online.eapcnet.eu and enter your password, or access via the EAPC website. (Access is available only to registered delegates).
- Read more posts about the 11th EAPC World Research Congress here. and selected video presentations on the EAPC YouTube Channel. (Access is available to everyone).
Editorial note: This post is among the Top Ten most-viewed posts on the EAPC blog in the second six months of 2020.