Application of Edmonton Symptom Assessment system in daily cancer pain management by acupuncture: Retrospective analysis of data from an inpatient oncology department and a pilot prospective study☆ 埃德蒙顿症状评估量表在针灸治疗癌痛患者中的应用:基于肿瘤科住院患者的回顾性分析和一项前瞻性预试验

Abstract

Background

As pain is the most prominent clinical symptom for cancer patients and closely related to other symptoms, it is necessary to have a comprehensive assessment on promising intervention to improve pain management.

Methods

A retrospective study of 489 inpatient cancer patients (1081 visits) was conducted by querying the electronic medical record database to test the reliability and validity of the Edmonton Symptom Assessment System. Data from a pilot prospective randomized controlled study on acupuncture for cancer pain was analyzed to validate the Edmonton Symptom Assessment System (ESAS) as the primary outcome in the integrative oncology research.

Results

In the retrospective analysis, scores of the numerical rating scale (NRS) and the ESAS total score were significantly correlated (r=0.15, P = 0.02), and the correlation coefficient between NRS and pain sub-scale in ESAS was 0.47 (P < 0.001). The pilot study showed the proportions of participants experiencing more than a 2-point reduction in NRS at the end of the treatment were 80% (n = 12/15) in the acupuncture group and 50% (n = 7/14) in the control group, without a significant difference between groups (P = 0.13). For the total scores of ESAS, more responders were found in the acupuncture group (n = 13/15) compared to that in the control group (n = 7/14), with no significant difference between groups (P = 0.05).

Conclusions

ESAS is suitable for the comprehensive assessment in patients with cancer pain and could be an appropriate outcome measurement in acupuncture research for cancer pain.

Trial registration

Registered on 09/07/2018 with ChiCTR1800017023 (https://www.chictr.org.cn/edit.aspx?pid=28879&htm=4)