Investigating the Effects of TTS-Fentanyl for Cancer Pain on the Psychological Status of Patients Naive to Strong Opioids: An Open Label Study

2004 
: Few studies have investigated the effect of fentanyl delivered via the transdermal route with regard to the patient's psychological status. Patients who were naive to strong opioids and were attending a palliative care unit for pain relief from advanced cancer participated in this study to determine the effect of transdermal therapeutic system fentanyl (TTS-F) on their psychological condition. Spielberger State-Trait Anxiety Inventory (STAI), Zung Self-Rating Depression Scale (SDS), the Karnofsky Performance Scale (100-0, optimum-death), and a Visual Analogue Scale (VAS) (0: no pain; 10: worst pain) were used to measure the level of pain. Data were collected at baseline (T0), on the 7th day (T1), and on the 14th day (T2) of TTS-F application in order to determine changes in correlation to TTS-F dose. Patients' status improved according to the Zung SDS questionnaire (P < .0005) and with each of its subscales (P < .05). A similar improvement was observed according to the Spielberger STAI questionnaire (P = .002). Moreover, VAS measures demonstrated that patients achieved significant pain relief (P < .0005), while patients' performance status did not alter significantly over the study period. Furthermore, the Zung SDS showed a statistically significant correlation when compared with the Spielberger STAI (P < .01). These data provide some evidence that the psychological status, as measured with respect to depression and anxiety in patients with advanced cancer, is improved in patients receiving TTS-fentanyl. Future research should use a broad range of psychological measurements in order to assist the development of practices, which are aimed at the improvement of quality of life in these patients.
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