{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:23:32Z","timestamp":1790720612809,"version":"4.1.0"},"reference-count":112,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001026","name":"Australian National Breast Cancer Foundation","doi-asserted-by":"crossref","award":["NT-14-008"],"award-info":[{"award-number":["NT-14-008"]}],"id":[{"id":"10.13039\/501100001026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>About 70% of patients with advanced cancer experience pain. Few studies have investigated the use of healthcare in this population and the relationship between pain intensity and costs.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Adults with advanced cancer and scored worst pain \u2265 2\/10 on a numeric rating scale (NRS) were recruited from 6 Australian oncology\/palliative care outpatient services to the Stop Cancer PAIN trial (08\/15-06\/19). Out-of-hospital, publicly funded services, prescriptions and costs were estimated for the three months before pain screening. Descriptive statistics summarize the clinico-demographic variables, health services and costs, treatments and pain scores. Relationships with costs were explored using Spearman correlations, Mann-Whitney U and Kruskal-Wallis tests, and a gamma log-link generalized linear model.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Overall, 212 participants had median worst pain scores of five (inter-quartile range 4). The most frequently prescribed medications were opioids (60.1%) and peptic ulcer\/gastro-oesophageal reflux disease (GORD) drugs (51.6%). The total average healthcare cost in the three months before the census date was A$6,742 (95% CI $5,637, $7,847), approximately $27,000 annually. Men had higher mean healthcare costs than women, adjusting for age, cancer type and pain levels (men $7,872, women $4,493, p&lt;0.01) and higher expenditure on prescriptions (men $5,559, women $2,034, p&lt;0.01).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>In this population with pain and cancer, there was no clear relationship between healthcare costs and pain severity. These treatment patterns requiring further exploration including the prevalence of peptic ulcer\/GORD drugs, and lipid lowering agents and the higher healthcare costs for men.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Trial registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.anzctr.org.au\/ACTRN12615000064505\" xlink:type=\"simple\">ACTRN12615000064505<\/jats:ext-link>. World Health Organisation unique trial number<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.who.int\/clinical-trials-registry-platform\/unambiguous-trial-identification\/the-universal-trial-number-(utn)\" xlink:type=\"simple\">U1111\u20131164\u20134649<\/jats:ext-link>. Registered 23 January 2015.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0282465","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T19:49:27Z","timestamp":1677613767000},"page":"e0282465","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3684-3723","authenticated-orcid":true,"given":"Nikki","family":"McCaffrey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Leang","family":"Cheah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Luckett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3691-8230","authenticated-orcid":true,"given":"Jane L.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Agar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M.","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Boyle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Currow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Lovell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"pone.0282465.ref001","first-page":"19","volume-title":"Cancer pain: assessment and management","author":"London","year":"2003"},{"issue":"6","key":"pone.0282465.ref002","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.jpainsymman.2015.12.340","article-title":"Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis","volume":"51","author":"MH van den Beuken-van Everdingen","year":"2016","journal-title":"J Pain Symptom Manage"},{"issue":"2","key":"pone.0282465.ref003","first-page":"141","volume":"35","author":"O Meads DM","year":"2019","journal-title":"Cost-Effectiveness of Pain Management Strategies in Advanced Cancer. 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