Adjuvant Analgesic Use for Cancer-Related Pain in Ambulatory Oncology Care

Supportive oncology improves quality of life and symptom control for patients with cancer. This retrospective cohort analysis compared adjuvant analgesic therapies across three ambulatory settings at a Midwest health system: the standard care models, including physician-led primary oncology and advanced practice provider–led supportive oncology (APP-SO), vs. an interprofessional collaborative practice supportive oncology (IPCP-SO) model with an integrated palliative care clinical pharmacist. The primary objective was to compare the median number of therapeutic adjuvants; secondary objectives were pain control and oral morphine equivalents (OME). Patients were 18 years or older with stage 3 or 4 cancer, cancer-related pain, and cancer-directed treatment. Random sampling yielded 75 patients per group (N = 225) from 2019–2025 records. Groups had comparable baseline characteristics (p > .05). IPCP-SO was associated with more adjuvants than physician-led primary oncology (incidence rate ratio [IRR] 8.17, 95% CI: 5.19–12.87, p < .001) and APP-SO (IRR 2.02, 95% CI: 1.52–2.69, p < .001). Median clinic-visit numeric rating scale reduction was 1 point in the standard-model cohorts and 3 points in IPCP-SO. Median last-visit OME was lowest in physician-led primary oncology. IPCP-SO was associated with greater adjuvant use and greater pain reduction than APP-SO and physician-led primary oncology.