BREAKTHROUGH CANCER PAIN, NEUROPATHIC PAIN FEATURES, AND OLDER AGE GREATLY INFLUENCE TELEMEDICINE-BASED FOLLOW-UP INTENSITY FOR CANCER PAIN MANAGEMENT

D. Esposito¹, S. Romano¹, M. Montedoro¹, S. De Angelis¹, G. Izzo¹, V. Cerrone¹, M.P. Bruno¹, F. Monaco², M. Cascella¹ | ¹Oncology, Ruggi Hospital, Salerno; ²ASL Napoli 1, Napoli

BACKGROUND
Cancer-related pain is a prevalent and debilitating symptom that significantly affects patients’ quality of life. Investigations demonstrated that the use of telemedicine management represents an effective strategy^1,2.
OBJECTIVE
To describe the clinical characteristics, pain profiles, pharmacological treatments, and patients’ features influenzing follow-up intensity of telemedicine consultations for pain control at the Ruggi Hospital (Salerno, Italy).
METHODS
A retrospective observational analysis was conducted on 126 cancer patients receiving telemedicine-based pain care between November 2023 and July 2024. Data on demographics, pain characteristics (intensity, type), diagnosis, treatments, and number of teleconsultations were collected.
RESULTS
Of 126 patients, 97 (77%) underwent multiple telemedicine visits (mean: 3.2 per patient; some ≥6). Mean age was 68 years (range: 41–89); 54% were female. ECOG performance status: 21% ECOG 1, 47% ECOG 2, 26% ECOG 3, 6% ECOG 4. Tumor types: breast (25%), lung (18%), colorectal (14%), pancreatic (10%), gastric (8%), prostate (7%), others (18%). Pain types: nociceptive (48%), neuropathic (22%), mixed (30%). Pain sites: multisite (38%), back (22%), limbs (16%), abdomen (12%), pelvic/perianal (8%), head/neck (4%).BTcP was reported in 62%, and rapid-onset opioids (ROOs) were used by 58%. BTcP patients had more televisits (mean: 3.8 vs. 2.1). Neuropathic pain patients averaged 3.6 televisits; mixed pain 3.4; nociceptive pain 2.3. Patients with ECOG 3–4 had more follow-ups (mean: 3.5 vs. 2.7 for ECOG 1–2). Multisite pain was linked to more visits (3.7 vs. 2.5 in localized pain).
CONCLUSIONS
Telemedicine is effective for cancer pain management, enabling individualized care. Patients with BTcP, neuropathic or multisite pain, older age, or worse functional status needed more frequent remote monitoring. These findings support the integration of telemedicine into oncologic pain care pathways.

Figure 1. Average number of telemedicine visits by patient characteristics.

Table 1. Multivariate linear regression identified factors significantly influencing the number of televisits per patient. Age, ECOG status, bone metastases, BTcP, ROOs, and antiepileptics were positively associated. Gender, diabetes, hypertension, and cardiovascular disease were not significant.