Nonwearable actigraphy to assess changes in motor activity before and after rescue analgesia in terminally ill patients with cancer: A pilot study.

AIMS This study aimed to investigate the usefulness of nonwearable actigraphy to assess changes in motor activity before and after rescue analgesic administration in terminally ill cancer patients. BACKGROUND Evaluating pain in terminally ill cancer patients is difficult; pain assessment tools are needed. METHODS This was an exploratory descriptive study conducted within a palliative care unit. A nonwearable actigraph was used to measure the activity score and movement index of terminally ill patients with weeks-long prognosis and pain. The actigraph and medical data were integrated, and data were compared 6 h before and after rescue analgesic administration. RESULTS Among 10 patients (age: 75.8 ± 12.3 years; six men), we evaluated 28 pain episodes (mean activity score: 130.9 ± 180.5 counts per minute; movement index: 68.8%). When pain was relieved at night following rescue analgesic administration, activity score and movement index decreased significantly (6 h before vs. 6 h after analgesics, respectively: 113.1 to 69.7 counts per minute; 64.3% to 41.8%; both p < 0.0001). With no relief after rescue analgesic administration, activity score did not differ significantly 6 h before and after analgesics: 147.3 to 137.7 counts per minute. CONCLUSION Pain in terminally ill cancer patients could be assessed using a nonwearable actigraph to capture motor activity and improve pain assessment.

[1]  Rachel McKee.  The Challenge of Cancer Pain Assessment , 2018, The Ulster medical journal.

[2]  P. Hoskin,et al.  Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. , 2018, Annals of Oncology.

[3]  Justin C. Brown,et al.  Barriers to physical activity: a study of academic and community cancer survivors with pain , 2018, Journal of Cancer Survivorship.

[4]  Joo-Young Lee,et al.  Effects of feet warming using bed socks on sleep quality and thermoregulatory responses in a cool environment , 2018, Journal of physiological anthropology.

[5]  L. Jones,et al.  The association between fatigue and pain symptoms and decreased physical activity after cancer , 2018, Supportive Care in Cancer.

[6]  S. Bush,et al.  Clinical Assessment and Management of Delirium in the Palliative Care Setting , 2017, Drugs.

[7]  N. Neufeld,et al.  Cancer pain: a review of epidemiology, clinical quality and value impact. , 2017, Future oncology.

[8]  Valentina Isetta,et al.  Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement , 2016, European Respiratory Journal.

[9]  R. Chou,et al.  CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. , 2016, JAMA.

[10]  L. Montanari,et al.  What to Do, and What Not to Do, When Diagnosing and Treating Breakthrough Cancer Pain (BTcP): Expert Opinion , 2016, Drugs.

[11]  L. Radbruch,et al.  EAPC White Paper on outcome measurement in palliative care: Improving practice, attaining outcomes and delivering quality services – Recommendations from the European Association for Palliative Care (EAPC) Task Force on Outcome Measurement , 2016, Palliative medicine.

[12]  R. Sean Morrison,et al.  Pain management in older adults. , 2013, Clinical therapeutics.

[13]  Masato Shimokawa,et al.  Automatic sleep/wake scoring from body motion in bed: validation of a newly developed sensor placed under a mattress. , 2011, Journal of physiological anthropology.

[14]  D. Marcus.  Epidemiology of Cancer Pain , 2011, Current pain and headache reports.

[15]  S. Kumar.  Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care , 2011, Indian journal of palliative care.

[16]  C. Møldrup,et al.  Patient-related barriers to cancer pain management: a systematic exploratory review. , 2009, Scandinavian journal of caring sciences.

[17]  C. Cleeland,et al.  Assessing persistent cancer pain: a comparison of current pain ratings and pain recalled from the past week. , 2009, Journal of pain and symptom management.

[18]  Michael G Downing,et al.  Meta-analysis of Survival Prediction with Palliative Performance Scale , 2007, Journal of palliative care.

[19]  Toshiaki Takahashi,et al.  The influence of peripheral intravenous catheterization on the sleep quality of ophthalmic inpatients: An observational study , 2021 .

[20]  Y. Inoue,et al.  Validation of a sheet-shaped body vibrometer for screening of obstructive sleep apnea. , 2017, Drug discoveries & therapeutics.

[21]  R. Gooberman-Hill,et al.  Opioid analgesics for cancer pain: symptom control for the living or comfort for the dying? A qualitative study to investigate the factors influencing the decision to accept morphine for pain caused by cancer. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.