The Opioid Rotation Ratio (ORR) from transdermal fentanyl (TDF) to strong opioids in cancer patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 182-182
Author(s):  
Akhila Sunkepally Reddy ◽  
Sriram Yennu ◽  
Suresh K. Reddy ◽  
Jimin Wu ◽  
Diane D Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Care Center ◽  
Linear Regression Analysis ◽  
Symptom Assessment ◽  
Cancer Center ◽  
Transdermal Fentanyl ◽  
Opioid Rotation ◽  
Edmonton Symptom Assessment Scale ◽  
Strong Opioids

182 Background: Despite being the most frequently prescribed strong opioid by oncologists, there is a lack of knowledge of the accurate the opioid rotation ratio (ORR) from transdermal fentanyl (TDF) to other strong opioids in cancer patients. Opioid rotation (OR) from TDF to other strong opioids is performed very frequently in cancer patients for uncontrolled pain or opioid induced neurotoxicity (OIN). The aim of our study was to determine the ORR of TDF to other strong opioids, as measured by morphine equivalent daily dose (MEDD). Methods: In this ad hoc analysis, we reviewed 2471 consecutive patient visits to the supportive care center of a tertiary cancer center in 2008 for an OR from TDF to other strong opioids by a palliative medicine specialist. Information regarding demographics, Edmonton Symptom Assessment Scale (ESAS), and MEDD were collected in patients who followed-up within 6 weeks. Linear regression analysis was used to estimate the ORR between TDF dose and net MEDD (MEDD after OR minus MEDD of breakthrough opioid used along with TDF before OR). Successful OR was defined as 2-point or 30% reduction in pain score and continuation of the new opioid at follow up. Results: 47/2471 patients underwent OR from TDF to other opioids and followed-up within 6 weeks. The median age was 54 years, 53% were male, and 77% had advanced cancer. The median time between OR and follow up was 14 days. Uncontrolled pain (83%) followed by OIN (15%) were the most frequent reasons for OR and 77% had a successful OR with significant improvement in ESAS pain and symptom distress scores. In patients with OR and no worsening of pain at follow-up (n = 41), the median ORR (range) from TDF mg/day to net MEDD was 100 (12.5-217), TDF mcg/hour to net MEDD was 2.4 (0.3-5.2), and correlation of TDF dose to net MEDD was .60 (P < 0.0001). Conclusions: The median ORR from TDF mg/day to MEDD is 100 and from TDF mcg/hour to MEDD is 2.4. Further validation studies are needed.

The conversion ratio for opioid rotation from hydrocodone to other strong opioids in cancer patients.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 164-164
Author(s):  
Akhila Sunkepally Reddy ◽  
Sriram Yennu ◽  
Jimin Wu ◽  
Diane Liu ◽  
Suresh K. Reddy ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Care Center ◽  
Linear Regression Analysis ◽  
Symptom Assessment ◽  
Conversion Ratio ◽  
Opioid Rotation ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Strong Opioids

164 Background: Cancer pain is initially treated with intermediate strength analgesics such as hydrocodone and subsequently escalated to stronger opioids. There are no studies on the process of opioid rotation (OR) from hydrocodone to strong opioids in cancer patients. Our aim was to determine the conversion ratio (CR) for OR from hydrocodone to morphine equivalent daily dose (MEDD) in cancer outpatients. Methods: We reviewed records of 3,144 consecutive patient visits at our Supportive Care Center in 2011-12 for OR from hydrocodone to stronger opioids. Data regarding demographics, Edmonton Symptom Assessment Scale (ESAS), and MEDD were collected in patients who returned for follow up within 6 weeks. Linear regression analysis was used to estimate the CR between hydrocodone and MEDD. Successful OR was defined as 2-point or 30% reduction in the pain score and continuation of the new opioid at follow up. Results: 170/3,144 patients underwent OR from hydrocodone to stronger opioid. 72% were white, 56% male, and 81% had advanced cancer. The median time between OR and follow up was 21 days. 53% had a successful OR with significant improvement in the ESAS pain and symptom distress scores. In 100 patients with complete OR and no worsening of pain at follow up, the median CR (Q1-Q3) from hydrocodone to MEDD was 1.5 (0.9-2) and hydrocodone dose to MEDD correlation was.52 (P<0.0001). The correlation of CR with hydrocodone dose was -0.52 (P<0.0001). The median CR of hydrocodone to MEDD was 2 in patients receiving < 40mg of hydrocodone/day and 1 in patients receiving ≥ 40mg of hydrocodone/day (P<0.0001). The median conversion ratio of hydrocodone to morphine was 1.5 (n=44) and hydrocodone to oxycodone was 0.9 (n=24). Conclusions: Hydrocodone is 1.5-fold stronger than Morphine. The median conversion ratio from hydrocodone to MEDD varied according to hydrocodone dose/day. [Table: see text]

The Opioid Rotation Ratio (ORR) to transdermal fentanyl (TDF) in cancer patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 181-181
Author(s):  
Akhila Sunkepally Reddy ◽  
Ali Haider ◽  
Supakarn Tayjasanant ◽  
Jimin Wu ◽  
Diane D Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Care Center ◽  
Linear Regression Analysis ◽  
Symptom Assessment ◽  
Transdermal Fentanyl ◽  
Opioid Rotation ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Frequent Reason

181 Background: Cancer patients frequently undergo opioid rotation (OR) for uncontrolled pain or opioid induced neurotoxicity. TDF is one of the most common opioids prescribed to cancer patients. However, the accurate ORR from other opioids to TDF is unknown and various currently used methods result in a wide variation of ORRs. Our aim was to determine the ORR of morphine equivalent daily dose (MEDD) to TDF when correcting for MEDD of breakthrough opioids (net MEDD) in cancer outpatients. Methods: We reviewed records of 22,532 consecutive patient visits at our Supportive Care Center in 2010-13 for OR from to TDF by a palliative medicine specialist. Data regarding Edmonton Symptom Assessment Scale (ESAS) and MEDD were collected in patients who returned for follow up within 5 weeks. Linear regression analysis was used to estimate the ORR between TDF dose and net MEDD (MEDD prior to OR minus MEDD of breakthrough opioid used along with TDF after OR). Successful OR was defined as 2-point or 30% reduction in pain score and continuation of the new opioid at follow up. Results: 129 patients underwent OR to TDF from other opioids. The mean age was 56 years, 59% male, and 88% had advanced cancer. The median time between OR and follow up was 14 days. Uncontrolled pain (80%) was the most frequent reason for OR and 59% had a successful OR with significant improvement in ESAS pain, constipation, and symptom distress scores. In 101 patients with OR and no worsening of pain at follow up, the median ORR (range) from net MEDD to TDF mg/day was .01 (-0.02-0.04) and correlation of TDF dose to net MEDD was .77 (P < .0001). The ORR was not significantly impacted by variables such as mucositis, serum albumin, and body mass index (BMI). The ORR of .01 suggests that MEDD of 100mg is equivalent to 1mg TDF/day or 40mcg/hour TDF patch (1000mcg/24hours). Conclusions: The median ORR from MEDD to TDF mg/day is .01 and the ORR from MEDD to TDF mcg/hour patch is 0.4. Further validation studies are needed. [Table: see text]

Survival among cancer patients undergoing opioid rotation to methadone as compared to other opioids.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 183-183
Author(s):  
Akhila Sunkepally Reddy ◽  
Sriram Yennu ◽  
Ulrich S. Schuler ◽  
Maxine Grace De la Cruz ◽  
Jimin Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
The Other ◽  
Pain Response ◽  
Opioid Rotation ◽  
Kaplan Meier ◽  
Methadone Group ◽  
Significant Difference ◽  
Edmonton Symptom Assessment Scale ◽  
Strong Opioids

183 Background: Recent studies have reported that methadone has antineoplastic activity. Other studies have associated methadone with lower overall survival in patients with chronic pain. Methadone is the most frequent opioid chosen for purpose of opioid rotation (OR) in cancer patients experiencing refractory pain or opioid induced neurotoxicity. There is no data available on the association of methadone with overall survival in cancer patients. Our aim was to compare the characteristics and overall survival in cancer patients in methadone group with other strong opioid group. Methods: In this ad hoc analysis, we reviewed 2471 consecutive patient visits to the supportive care center of a tertiary cancer center in 2008 for ORs from strong opioids to methadone or other strong opioids with a follow-up visit within 6 weeks. Information regarding demographics, Edmonton Symptom Assessment Scale (ESAS), and morphine equivalent daily dose (MEDD) were collected. Successful pain response was defined as 2-point or 30% reduction in pain score. Kaplan-Meier curves were used to evaluate survival. Results: Of the 102 eligible patients, 54 underwent OR to methadone and 48 to other strong opioids. The median age was 56 years, 56% were male, and 81% had advanced cancer. There were no significant differences between the methadone group and the other opioid group in patient characteristics, performance status, MEDD, and ESAS scores. Although both the groups showed significant pain response, methadone group (72%) had a significantly higher pain response as compared to the other opioid group (65%; P = 0.04). The Kaplan-Meier curves revealed no significant difference in overall survival (OS) between the methadone group and the other opioid group [median OS: 5.2 months (95% CI 3.64-7.41) vs. 5.9 months (95% CI 2.6-9.2); P = 0.89]. Conclusions: We observed no significant difference in overall survival in cancer patients in methadone group as compared to other opioids. Further validation studies in a larger sample are warranted.

The influence of a cachexia clinic on palliative care integration in oncology.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 124-124
Author(s):  
Diane Portman ◽  
Sarah Thirlwell ◽  
Kristine A. Donovan
Keyword(s):  
Palliative Care ◽  
Weight Loss ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
The Impact

124 Background: Appetite and weight loss are common in patients with advanced cancer and specialized cachexia clinics have been established to address these symptoms. Given the association between anorexia/cachexia and other adverse symptoms, these patients may also benefit from specialty level palliative care (PC). However, referral to outpatient specialty level PC is often delayed or does not occur. We sought to examine the prevalence of other factors associated with appetite and weight loss in patients with advanced cancer and the impact of a specialized cachexia clinic on identification and treatment of other PC needs. Methods: The records of patients referred by their Oncologist to the cachexia clinic of a cancer center from August 2016 to June 2017 were reviewed retrospectively. Subjects who had been referred to PC by their Oncologist were excluded. Patients had been assessed for symptom burden using the Edmonton Symptom Assessment Scale (ESAS-r). Patients identified with PC needs had been referred to the PC clinic for follow-up within 30 days after cachexia clinic consultation. Results: Thirty subjects were evaluated in the cachexia clinic (average age 68 years; 63% female). The predominant diagnosis was lung cancer (70%). An average of 6 symptoms per patient were in the moderate to severe range on ESAS, excluding appetite. Depression, fatigue and pain were most common. The average cachexia clinic total ESAS score was 51.61. Only 17% of patients had completed advance directives. Ninety-three % of patients were referred to PC and 68% were seen. The average number of PC visits was 2.79. Within the PC clinic, advance directive completion increased to 37%, goals of care discussion occurred with 50% and 17% received hospice referrals. At the most recent follow-up in the PC clinic, the average total ESAS score had decreased by 11.44 (22%) and all ESAS item scores were improved on average. Conclusions: The cachexia clinic proved a useful means to identify other PC needs and achieve effective PC referrals. We suggest this is proof of concept that specialty clinics can be a meaningful way to achieve an earlier entry point to comprehensive PC in patients who were not previously referred by their Oncologists.

Patients’ characteristics and outcomes of palliative care inpatient consults at a comprehensive cancer center

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8524-8524 ◽  
Author(s):  
B. El Osta ◽  
F. S. Braiteh ◽  
S. Reddy ◽  
H. El Osta ◽  
E. Bruera
Keyword(s):  
Palliative Care ◽  
Symptom Assessment ◽  
Disease Diagnosis ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Limited Information ◽  
Opioid Rotation ◽  
Cancer Data ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale

8524 Background: There is limited information about the characteristics and outcomes of inpatient palliative care consults in cancer centers. Two mobile teams (MT) each with a physician, fellow, and a nurse, provide consultation to hospitalized patients (pts) with complex symptoms. Methods: We analyzed the pts characteristics and outcomes during a two-month period. The charts were reviewed for demographics, cancer data, reason for consultation, symptoms, interventions, and outcomes. Results: Sixty-one pts were analyzed. Pain was the main reason for a consult request in 46 pts (75%), delirium in 10 (16%), anxiety in 4 (7%) and constipation in 5 (8 %). Some pts had more than one reason. 56(92%) pts had metastatic disease, diagnosis for ≤1 year in 26 (42%) and ≤2 years in 44 (72%) (Median =17 months). The Edmonton Symptom Assessment Scale (ESAS), 0–10, is summarized in the table. We uncovered new issues at consultation, such as 20 pts (38%) screened positive for alcoholism with CAGE questionnaire and the 34 pts (56%) had clinical delirium. Features of opioids toxicity such as constipation (N=43;70%), confusion (N=35;57%) (Mean MMSE = 23 ± 5), hallucinations (N=21;34%), myoclonus (N=16;26%) and miosis (N=18;29%) were frequently identified. The MT interventions included imaging studies (23%), enema (43%), laxatives (49%), neuroleptics (54%), metoclopramide (39%), corticosteroids (25%). Half (N=30;50%) of the pts had opioid rotation and/or had counseling (N=27;46%). One out of two pts (N=30;49%) required transfer to the palliative care unit. Conclusions: Most pts had previously undiagnosed opioid toxicity, delirium, and other symptoms. Opioid toxicity occurred secondary to rapid opioid escalation, possibly linked to chemical coping, and psychosocial distress. The outcome of these pts improved by opioid rotation, adding laxatives, metoclopramide, neuroleptics, and steroids. [Table: see text] No significant financial relationships to disclose.

scholarly journals Inpatient Acupuncture at a Major Cancer Center

2017 ◽  
Vol 17 (1) ◽  
pp. 148-152 ◽  
Author(s):  
M. Kay Garcia ◽  
Lorenzo Cohen ◽  
Michael Spano ◽  
Amy Spelman ◽  
Yousra Hashmi ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Symptom Assessment ◽  
Post Treatment ◽  
Hospital Environment ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale ◽  
Before And After ◽  
Integrative Therapies ◽  
The Impact

Background: Use of complementary and integrative therapies is increasing among cancer patients, but data regarding the impact treatments such as acupuncture have in an inpatient oncology setting are limited. Methods: Patients who received acupuncture in an inpatient hospital environment between December 2014 and December 2015 were asked to complete a modified Edmonton Symptom Assessment Scale (ESAS; 0-10 scale) before and after each visit. Pre- and post-treatment scores were examined for each symptom using paired t tests. Results: A total of 172 inpatients were treated with acupuncture in their hospital beds (257 visits). Thirty percent (n = 51) received at least one additional follow-up treatment (mean visits/patient = 1.5). Completion rate of the modified ESAS after acupuncture was 42%. The most common reasons for not completing the post-treatment ESAS were “patient too drowsy” or “patient fell asleep” (72%). For patients who reported a baseline symptom score ≥1, the greatest improvements (mean change ± SD) after acupuncture on the initial visit were found for pain (−1.8 ± 2.2; n = 69; P < .0001), nausea (−1.2 ± 1.9; n = 30; P < .001), anxiety (−0.8 ± 1.8; n = 36; P = .01), drowsiness (−0.6 ± 1.8; n = 57; P = .02), and fatigue (−0.4 ± 1.1; n = 67; P = .008). For patients who received at least one follow-up visit, significant improvement from baseline was found for sleep disturbance (−2.5 ± 4.4; n = 17; P = .03), anxiety (−2.4 ± 1.7; n = 9; P = .002), pain (−2.3 ± 2.7; n = 20; P = .001), and drowsiness (−2.0 ± 2.6; n = 16; P = .008). Conclusions: Patients who received inpatient acupuncture at a major cancer center experienced significant improvement after treatment for pain, sleep disturbance, anxiety, drowsiness, nausea, and fatigue.

Frequency, indications, outcomes, and factors associated with successful opioid rotation in cancer patients presenting to an outpatient supportive care center.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19599-e19599
Author(s):  
Akhila Sunkepally Reddy ◽  
Sriram Yennurajalingam ◽  
Kalyan Pulivarthi ◽  
Jung Hye Kwon ◽  
Susan Frisbee-Hume ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Care Center ◽  
Assessment Scale ◽  
Opioid Rotation ◽  
Factors Associated ◽  
Outpatient Visits ◽  
Pain Characteristics

e19599 Background: Opioids are first line medications for cancer pain. Opioid rotation (OR) is recommended for uncontrolled cancer pain (UCP) and opioid induced neurotoxicity (OIN). Limited data exist on frequency, indications and outcomes of OR in ambulatory cancer patients in outpatient setting. Methods: We reviewed consecutive outpatient visits to the Supportive Care Center in 2008 for OR. Data regarding demographics, Edmonton Symptom Assessment Scale (ESAS), Memorial Delirium Assessment Scale, pain characteristics, opioid use, indication for OR, outcomes, morphine equivalent daily dose (MEDD) and supportive counseling was collected in all patient visits who followed up within 5 weeks of OR. Successful OR was defined as a 2 point or 30% reduction in ESAS symptom score, resolved symptoms of OIN and continuation of new opioid at follow up. Stepwise logistic regression analysis was performed to determine factors associated with successful OR. Results: 244/2471(10%) patient visits had OR and 142 (58%) were followed up within 5 weeks. 40% (57/142) were consult visits. 74% (105/142) were white, 60% (85/142) male. Median age and performance status were 55 and 1. GI (24%) and lung (22%) were the most common cancer types with 77% (110/142) advanced cancer. Median time (Q1-Q3) between OR and follow up was 14 (7-21) days. Most common indications for OR were UCP 82% and OIN 13%. 34% had partial OR and 16% had more than one reason for OR. Pain characteristics were 49% nociceptive, 21% mixed and 11% neuropathic. Median (Q1-Q3) pain and symptom distress score improved: -2 (-4-0, P=.003) and -5 (-14-7, P=.004). Median MEDD (Q1-Q3) decreased from 162 (90-287) to 156 (90-280, P=.82). 66% (94/142) had successful OR. Fentanyl (34%) before and Methadone (55%) after OR were most common opioids. 17% (24/142) had another OR at follow up visit. High MEDD (P=.05) prior to OR was associated with successful OR. Conclusions: 10% of outpatient visits had OR with a 66% success rate in treating UCP and OIN. Further research is needed to determine predictors of successful OR.

Referral patterns and characteristics of uninsured versus insured patients referred to the outpatient supportive care center (SCC) at a comprehensive cancer center.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 116-116
Author(s):  
Ahsan Azhar ◽  
Sriram Yennu ◽  
Aashraya Ramu ◽  
Haibo Zhang ◽  
Ali Haider ◽  
...  
Keyword(s):  
Low Income ◽  
Care Center ◽  
Symptom Assessment ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Referral Patterns ◽  
Edmonton Symptom Assessment Scale ◽  
Symptom Assessment Scale ◽  
Outpatient Supportive Care ◽  
Insured Patients

116 Background: Multiple barriers exist in providing quality palliative care to low-income patients with cancer. Such disparities may negatively influence effective management of symptoms including pain. Our objective was to compare referral patterns and characteristics (level of symptom distress) of uninsured vs insured patients. Methods: We reviewed randomly selected charts of 100 Indigent (IND) and 100 Medicaid (MC) patients and compared them with a random sample of 300 patients with insurance (INS) referred during the same time period (1/2010 to 12/2014) to our SCC. Data was collected for date of registration at the cancer center, diagnosis of Advanced Cancer (ACD), first visit to the SCC (PC1), symptom assessment (Edmonton Symptom Assessment Scale-ESAS) at PC1. We excluded self-pay patients. Results: Results for IND, MC and INS (n = 481) respectively are as follows: Mean (SD) Age in yrs. was 50 (12), 48 (11) and 63 (13); p < 0.001. Percentage of non-white was 44%, 51% and 19.5%; p < 0.001. Percentage of unmarried patients was 64%, 68% and 33%; p < 0.001. Mean (SD) ESAS score at PC1 for pain was 5.6 (3.2), 6.7 (2.5), 4.9 (3.2); p < 0.001. Percentage of patients on opioids upon referral was 86%, 62%, and 54%; p < 0.001. Mean (SD) for referral time in months from ACD to PC1 was 8.7 (SD 10.4), 12.3 (SD 18.1) and 12 (SD 19.9) p = 0.31; for no. of encounters with SC per month were 0.46 (0.45), 0.41 (0.46) and 0.3 (0.55); p = 0.01; for survival in months (PC1 to last contact) was 6.4 (5.8), 5.6 (6.4) & 6 (7.22) p = 0.77. Conclusions: Uninsured patients had significantly higher levels of pain, were more frequently on opioids, younger, non-white and not married. They also required a larger number of SCC encounters. Insurance status did not impact timing of SCC referral or SCC follow ups at our cancer center.

Frequency of concomitant use of opioids and psychoactive medications among cancer patients referred to outpatient palliative care at a comprehensive cancer center.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 240-240
Author(s):  
Ahsan Azhar ◽  
Ali Haider ◽  
Angelique Wong ◽  
Maria Agustina Cerana ◽  
Madhuri Adabala ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Care Center ◽  
Symptom Assessment ◽  
Comprehensive Cancer Center ◽  
Categorical Variables ◽  
Cancer Center ◽  
Continuous Variables ◽  
Exact Test ◽  
Psychoactive Medications

240 Background: There are potential severe effects when patients taking opioids receive other psychoactive medications. However, such combinations are sometimes necessary in palliative care. The purpose of this study was to determine the frequency of concomitant use of opioids + psychoactive medications in cancer patients referred to our outpatient palliative care center. Methods: Retrospective data obtained from consecutive consults was analyzed to determine the frequency of patients on opioids alone versus concomitant opioids + psychoactive medications at first presentation to our clinic. Association of type of medication with demographics and baseline characteristics was evaluated by Wilcoxon rank sum test for continuous variables and Chi-square (Fisher's exact) test for categorical variables. Results: Among 541 consecutive consult visits, 365 (67%) patients were taking opioids at the time of referral to our clinic: 209 (57%) were on opioids alone while 156 (43%) were on concomitant opioids + psychoactive medications [69 (44%) were on Opioid + Benzodiazepine, 46 (30%) were Opioid + Antidepressants, 41(26%) were on both). Patients in the concomitant groups were on higher Morphine Equivalent Daily Dose (MEDD, p = 0.007), had higher Edmonton Symptom Assessment Scores (ESAS) for pain (p = 0.017), anxiety (p < 0.001), depression (p < 0.001) and spiritual pain (p = 0.03). Conclusions: A large proportion (156, 43%) of cancer patients referred to outpatient palliative care was on concomitant opioids + psychoactive medications. These patients were on higher doses of opioids with higher levels of pain and psycho-social distress at the time of first presentation. Further studies are required to better understand the clinical implications of concomitant use of opioids + psychoactive medications in such patients.

Total relaxation: A Buddhist mindfulness-based intervention pilot studies in laypersons and cancer patients.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 187-187
Author(s):  
Suthida Suwanvecho ◽  
Buntharika Suwanvecho ◽  
Krit Pongpirul
Keyword(s):  
Cancer Patients ◽  
Symptom Assessment ◽  
Group Session ◽  
Cancer Center ◽  
Pilot Studies ◽  
Edmonton Symptom Assessment Scale ◽  
Before And After ◽  
The Mean ◽  
Symptom Assessment Scale ◽  
Mean Differences

187 Background: Total relaxation (TR), a mindfulness-based intervention based on the Buddha’s teaching of Sutra on Full Awareness of Breathing (Anapanasati Sutta) and Sutra on the Four Establishments of Mindfulness (Satipatthana Sutta). This study was aimed (1) to explore benefits of TR perceived by laypersons and (2) to share experience in piloting the intervention in cancer patients. Methods: Laypersons who attended the 5 - day retreat program with daily TR sessions at Khao Yai, Nakhon Ratchasima, Thailand during October 22-26, 2014 responded to the Edmonton Symptom Assessment Scale (ESAS) before and after the TR session on the first day (TR1 Before, TR1 After) and after the fourth TR session (TR4 After). ESAS was responded by cancer patients who visited Horizon Cancer Center, Bumrungrad International Hospital before and after their participation in a 45 minute TR group session. Paired t-test was used to evaluate the before-after difference in score of each matched variables. Results: Of 162 laypersons, 90.74% responded. They reported a significant improvement of all ESAS items (p < 0.001). Ten cancer patients (6 breast, 2 colon, and 1 stomach cancers and 1 lymphoma) who participated in the TR group session also saw the improvement of all ESAS items, with the mean differences ranging from 0.36 (feeling depressed) to 3.09 points (fatigue/tiredness). No adverse events were observed. Conclusions: Total relaxation is a Buddhist mindfulness-based technique that can improve undesirable symptoms of layperson and cancer patients.

Sign in / Sign up

Export Citation Format

Share Document