Outpatient Pain Medication Use: An Electronic Daily Diary Study in Metastatic Breast Cancer

Context. Understanding cancer patients' everyday pain experiences and their concomitant use of pain medication may help identify ways to improve pain management among outpatients. Objectives. This study examined the between-person and within-person associations between pain intensity and analgesic use in metastatic breast cancer patients. Methods. Fifty-three women who were initiating treatment for metastatic breast cancer completed electronic diary assessments six times per day for 14 days. Results. The likelihood of taking medication was found to depend on patients' average pain levels and on whether their pain was better or worse than usual at the time. Patients who typically experienced moderate-to-high pain were more likely to be prescribed and to take analgesics than were patients who typically experienced low pain. However, these patients tended not to vary their medication use based on within-person fluctuations in pain. In contrast, patients who typically experienced low pain tended to increase their medication use at times when their pain was higher than usual but were less likely to use medication than were patients who typically experienced higher levels of pain. Conclusion. Our findings provide some evidence that patients with advanced cancer tend to use their pain medications appropriately. Patients with lower pain appear to be taking medications in response to increases in pain, whereas patients whose pain is typically more intense may be relying on other cues to prompt them to take analgesic medication. Clinicians may need to be sensitive to individual differences in the factors associated with pain medication use in daily life. (C) 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.