PMID- 31190161
OWN - NLM
STAT- MEDLINE
DCOM- 20200330
LR  - 20200330
IS  - 1433-7339 (Electronic)
IS  - 0941-4355 (Linking)
VI  - 28
IP  - 3
DP  - 2020 Mar
TI  - Personalized goal for insomnia and clinical response in advanced cancer patients.
PG  - 1089-1096
LID - 10.1007/s00520-019-04912-z [doi]
AB  - AIM: The aim of this study was to assess the Personalized Insomnia Intensity Goal 
      (PIIG), the achievement of Personalized Goal Response (PGR), and Patient Global 
      Impression (PGI) after a comprehensive symptom management. PATIENTS AND METHODS: 
      Advanced cancer patients admitted to palliative care units rated pain and 
      symptoms intensity and their PIIG by using the Edmonton Symptom Assessment Score 
      (ESAS) (T0). In patients with significant levels of insomnia, the achievement of 
      target expected (PIIG) was measured (patient goal response, PIGR), as well the 
      patient global impression (PGI), by the minimal clinically important difference 
      (MCID), after a comprehensive symptom management (T7). RESULTS: Three hundred 
      ninety-seven patients with a level of insomnia of >/= 3 on ESAS were analyzed in 
      this study. The mean values of PIIG at T0 and T7 were 1.2 (SD 1.5) and 0.9 (SD 
      1.4), respectively. Most patients (n = 406, 89.8%) indicated a PIIG of </= 3 as a 
      target at T0. Such target was significantly lower at T7 (p = < 0.0005). PGI, 
      expressed as MCID, was perceived with a mean decrease in insomnia intensity of 
      - 2.3. In a minority of patients (n = 26; 5.8%) insomnia worsened, with a MCID of 
      0.50 (SD 2.8). Higher insomnia intensity at T0 and lower insomnia intensity at T7 
      were independently related to PGI. PIGR was achieved in 87.9% of patients. PIGR 
      was associated with PIIG at T0, and inversely associated to insomnia intensity at 
      T0 and T7, and PIIG at T7. CONCLUSION: PGIR and PGI seem to be relevant for 
      evaluating the effects of a comprehensive management of insomnia, suggesting 
      therapeutic decisions according to PIIG. Some factors influencing the individual 
      target and clinical response have been detected.
FAU - Mercadante, Sebastiano
AU  - Mercadante S
AD  - Main Regional Center for Pain Relief & Supportive Care, La Maddalena Cancer 
      Center, Via San Lorenzo 312, 90145, Palermo, Italy. 
      terapiadeldolore@lamaddalenanet.it.
FAU - Adile, Claudio
AU  - Adile C
AD  - Pain Relief & Supportive Care, La Maddalena Cancer Center, Palermo, Italy.
FAU - Aielli, Federica
AU  - Aielli F
AD  - Department of Oncology, Hospital of Teramo, Teramo, Italy.
FAU - Gaetano, Lanzetta
AU  - Gaetano L
AD  - Medical Oncology Unit, IRCCS Neuromed, Pozzilli, Italy.
AD  - Medical Oncology Unit, Italian Neuro-Traumatology Institute, Grottaferrata, 
      Italy.
FAU - Mistakidou, Kyriaki
AU  - Mistakidou K
AD  - Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, 
      National & Kapodistrian University of Athens, School of Medicine, Athens, Greece.
FAU - Maltoni, Marco
AU  - Maltoni M
AD  - Palliative Care Unit - Istituto Scientifico Romagnolo per lo Studio e la Cura dei 
      Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Cortegiani, Andrea
AU  - Cortegiani A
AD  - Department of Anesthesioloogy, University of Palermo, Palermo, PA, Italy.
FAU - Soares, Luiz Guilherme
AU  - Soares LG
AD  - Post-Acute Care Services and Palliative Care Program, Hospital Placi, Niteroi, 
      Rio de Janeiro, Brazil.
FAU - De Santis, Stefano
AU  - De Santis S
AD  - Palliative Care and Oncologic Pain Service - S. Camillo-Forlanini Hospital, Rome, 
      Italy.
FAU - Ferrera, Patrizia
AU  - Ferrera P
AD  - Pain Relief & Supportive Care, La Maddalena Cancer Center, Palermo, Italy.
FAU - Rosati, Marta
AU  - Rosati M
AD  - Palliative Care Unit - Istituto Scientifico Romagnolo per lo Studio e la Cura dei 
      Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Rossi, Romina
AU  - Rossi R
AD  - Palliative Care Unit - Istituto Scientifico Romagnolo per lo Studio e la Cura dei 
      Tumori (IRST) IRCCS, Meldola, Italy.
FAU - Casuccio, Alessandra
AU  - Casuccio A
AD  - Universita di Palermo, Palermo, Italy.
LA  - eng
PT  - Journal Article
DEP - 20190612
PL  - Germany
TA  - Support Care Cancer
JT  - Supportive care in cancer : official journal of the Multinational Association of 
      Supportive Care in Cancer
JID - 9302957
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Decision Making
MH  - Female
MH  - Goals
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*psychology/therapy
MH  - Pain/diagnosis
MH  - Pain Management/*methods
MH  - Palliative Care/*methods
MH  - Sleep Initiation and Maintenance Disorders/complications/*therapy
MH  - Symptom Assessment
OTO - NOTNLM
OT  - Advanced cancer
OT  - Global impression of change
OT  - Insomnia
OT  - Palliative care
OT  - Personalized symptom goal
OT  - Symptom assessment
EDAT- 2019/06/14 06:00
MHDA- 2020/03/31 06:00
CRDT- 2019/06/14 06:00
PHST- 2019/01/30 00:00 [received]
PHST- 2019/05/31 00:00 [accepted]
PHST- 2019/06/14 06:00 [pubmed]
PHST- 2020/03/31 06:00 [medline]
PHST- 2019/06/14 06:00 [entrez]
AID - 10.1007/s00520-019-04912-z [pii]
AID - 10.1007/s00520-019-04912-z [doi]
PST - ppublish
SO  - Support Care Cancer. 2020 Mar;28(3):1089-1096. doi: 10.1007/s00520-019-04912-z. 
      Epub 2019 Jun 12.