Frailty and Persistent Pain in Oncological Patients Undergoing Rehabilitation

Objectives: Pain is one of the most common symptoms among oncological patients and has a strong negative impact on quality of life. The aim of this study is to assess if frailty and polypharmacy are associated with persistent pain in oncological patients undergoing rehabilitation. Design: Observational, prospective, longitudinal study. Setting and Participants: Data are from oncological patients admitted to the Oncological Rehabilitation Unit. Methods: Presence of pain, its intensity and characteristics were evaluated at the admission and after 7 days. A Frailty Index (FI) was computed from Comprehensive Geriatric Assessment (CGA) data. Results: Among the 45 consecutively recruited patients (mean age 72 years, woman 44%), pain was present in 20 (44%) patients at the admission and 9 (20%) after 7 days of stay. Forty-one patients (92%) were taking more than 5 drugs at the admission (mean 9 drugs). The FI was normally distributed and descriptive statistics define our population as frail (mean 0.44; range 0.23–0.64). The FI was significantly associated with the presence of pain (OR 2.66; 95%CI 1.13–6.27, p=0.03) and its intensity after 7 days from the admission (β 4.24 95% CI 1.28–7.19, p=0.006), even after adjustment for potential confounders. Conclusions and Implications: Investigating frailty in cancer patients to implement multidisciplinary strategies could play an important role in improving persistent pain.