Guinigundo Andrew S, Maxwell Cathy L, Vanni Linda, Morrow Phuong Khanh, Reiner Maureen, Shih Alex, Klippel Zandra, Blanchard Elizabeth
Oncology Hematology Care Inc., Cincinnati, Ohio.
TESARO Inc., Waltham, Massachusetts.
Pain Manag Nurs. 2018 Dec;19(6):693-706. doi: 10.1016/j.pmn.2018.04.002. Epub 2018 Jun 21.
Mild-to-moderate bone pain is the most commonly reported adverse event associated with pegfilgrastim.
To investigate the effect of bone pain education on pegfilgrastim-related bone pain in patients with breast cancer receiving chemotherapy and pegfilgrastim.
Randomized, single-blind study.
Forty-eight community oncology clinics throughout the United States.
Three hundred women ≥18 years of age with newly diagnosed stage I -III breast cancer, who were planning ≥4 cycles of neoadjuvant or adjuvant chemotherapy with pegfilgrastim support starting in cycle 1.
Patients were randomized 1:1 to view a general education DVD on chemotherapy side effects (GE-DVD) or a DVD on bone pain following chemotherapy and pegfilgrastim (BP-DVD). Patients recorded severity of bone pain on a scale of 0-10, location of pain, and use of bone pain medications (i.e., analgesics, antihistamines, and nonsteroidal anti-inflammatory drugs) for 5 days, beginning on the day of pegfilgrastim administration, in each of the first four chemotherapy cycles.
Patient-reported maximum bone pain was similar in the two groups (GE-DVD vs BP-DVD: cycle 1, 3.2 vs. 3.5, p = .3479; across all cycles, 4.1 vs. 4.6, p = .2196). Other measures of bone pain were also similar between the groups. Bone pain was highest in cycle 1 but decreased and then remained stable in subsequent cycles. Bone pain medication use was similar in both groups and was highest in cycle 1.
The bone pain-specific education evaluated here did not improve perceptions of bone pain reported in this patient population.
