Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries

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Abstract:
In order to implement more effective policies for cancer pain management, a better understanding of current practices is needed. Physicians managing cancer pain and patients experiencing cancer pain were randomly surveyed across 10 Asian countries to assess attitudes and perceptions toward cancer pain management. A total of 463 physicians (77.3% oncologists) with a median experience of 13 years were included. Medical school training on opioid use was considered inadequate by 30.5% of physicians and 55.9% indicated ≤10 h of continuing medical education (CME). Of the 1190 patients included, 1026 reported moderate-to-severe pain (median duration, 12 months). Discordance was observed between physician and patient outcomes on pain assessment with 88.3% of physicians reporting pain quantification, while 49.5% of patients claimed that no scale was used. Inadequate assessment of pain was recognized as a barrier to therapy optimization by 49.7% of physicians. Additional barriers identified were patients' reluctance owing to fear of addiction (67.2%) and adverse events (65.0%), patients' reluctance to report pain (52.5%), excessive regulations (48.0%) and reluctance to prescribe opioids (42.8%). Opioid use was confirmed only in 53.2% (286/538) of patients remembering their medication. Pain affected the activities of daily living for 81.3% of patients. These findings highlight the need for better training and CME opportunities for cancer pain management in Asia. Collaborative efforts between physicians, patients, policy makers, and related parties may assist in overcoming the barriers identified. Addressing the opioid stigma and enhancing awareness is vital to improving current standards of patient care.

Keywords:
Cancer pain; pain management survey

Autoři: The Acheon Working Group; Yong-Chul Kim ^1,*; Jin Seok Ahn ²; Maria Minerva P. Calimag ³; Ta Chung Chao ^4,5; Kok Yuen Ho ⁶; Lye Mun Tho ⁷; Zhong-Jun Xia ⁸; Lois Ward ⁹; Hanlim Moon ¹⁰; Abhishek Bhagat ¹⁰
Působiště autorů: Department of Anesthesiology and Pain Medicine, Seoul National University School of Medicine, Seoul, Korea ¹; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ²; Departments of Pharmacology, Clinical Epidemiology and Anesthesiology, University of Santo Tomas Faculty of Medicine and Surgery and the UST Hospital, Manila, Philippines ³; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, China ⁴; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, China ⁵; Pain Management Service, Raffles Hospital, Singapore, Singapore ⁶; Department of Clinical Oncology, Beacon International Specialist Centre, Selangor, Malaysia ⁷; Sun Yat-Sen University Cancer Center, Guangzhou, China ⁸; Mundipharma Research Ltd, Cambridge, United Kingdom ⁹; Mundipharma Pte Ltd, Singapore, Singapore ¹⁰
Vyšlo v časopise: Cancer Medicine 2015; 4(8)
Kategorie: Original Research
prolekare.web.journal.doi_sk: https://doi.org/10.1002/cam4.471

© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Souhrn

Keywords:
Cancer pain; pain management survey

Zdroje

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