QUALITY-OF-LIFE AND CANCER PAIN - SATISFACTION AND SIDE-EFFECTS WITH TRANSDERMAL FENTANYL VERSUS ORAL MORPHINE

Purpose: To compare pain-related treatment satisfaction, patient-perce ived side effects, functioning, and well-being in patients with advanc ed cancer who were receiving either transdermal fentanyl (Duragesic, J anssen Pharmaceuticals, Titusville, NJ) or sustained-release oral form s of morphine (MS Contin, Perdue Frederick Co, Norwalk, CT, or Oramorp h SR, Roxanne Laboratories, Columbus, OH). Patients and Methods: A tot al of 504 assessable cancer patients participated in this cross-sectio nal, quality-of-life study. Relevant elements of four validated scales were used-the Functional Assessment of Cancer Therapy-General (FACT-G ) scale, the Brief Pain Inventory (BPI), the Medical Outcomes Study (M OS) questionnaire, and the Memorial Symptom Assessment Scale (MSAS)-as well as original scales that were developed and validated for this st udy. Results: The majority of patients in both treatment groups had la te-stage (IV/D) cancer. Patients who received transdermal fentanyl wer e more satisfied overall with their pain medication than those who rec eived sustained-release oral forms of morphine (P = .035). Fentanyl pa tients also experienced a significantly lower frequency (P < .002) and impact (P < .001) of pain medication side effects, These results occu rred despite the fact that cancer patients who received fentanyl were significantly older (P < .001) and had significantly lower functioning and well-being scores (P = .001). Measures of pain intensity, sleep a dequacy, and symptoms demonstrated no significant differences between treatment groups. Conclusion: These data suggest that patients are mor e satisfied with transdermal fentanyl compared with sustained-release oral forms of morphine, A lower frequency and reduced impact of side e ffects with transdermal fentanyl may be one reason cancer patients who receive fentanyl are more satisfied with their pain management. (C) 1 998 by American Society of Clinical Oncology.