Lack of Adherence With the Analgesic Regimen: A Significant Barrier to Effective Cancer Pain Management

2001 ◽  
Vol 19 (23) ◽  
pp. 4275-4279 ◽  
Author(s):  
Christine Miaskowski ◽  
Marylin J. Dodd ◽  
Claudia West ◽  
Steven M. Paul ◽  
Debu Tripathy ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Opioid Analgesics ◽  
Daily Basis ◽  
Pain Intensity Score ◽  
Cancer Pain Management ◽  
Analgesic Regimen

PURPOSE: To evaluate oncology outpatients’ level of adherence to their analgesic regimen during a 5-week period. PATIENTS AND METHODS: A random sample of 65 adult oncology outpatients with a Karnofsky performance status score of ≥ 50, an average pain intensity score of ≥ 2.5, and radiographic evidence of bone metastasis were recruited for this longitudinal study from seven outpatient settings. On a daily basis, patients rated their level of pain intensity and recorded pain medication intake. Adherence rates for opioid analgesics prescribed on an around-the-clock (ATC) and on an as-needed (PRN) basis were calculated on a weekly basis. RESULTS: Overall adherence rates for ATC opioid analgesics ranged from 84.5% to 90.8% and, for PRN analgesics, from 22.2% to 26.6%. No significant differences over time were found in either of these adherence rates. CONCLUSION: One factor that seems to contribute to ineffective cancer pain management is poor adherence to the analgesic regimen.

Oxycodone Immediate Release for Cancer Pain Management in Turkey: Maximizing Value in Opioid Analgesics

2014 ◽  
Vol 3 (4) ◽  
pp. 207-217
Author(s):  
Robert Jr ◽  
◽  
Joseph Jr. ◽  
Gianpietro Zampogna ◽  
Fuat Demirelli ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Opioid Analgesics ◽  
Immediate Release ◽  
Cancer Pain Management

Physician-related barriers to cancer pain management with opioid analgesics: A systematic review

2007 ◽  
Vol 3 (4) ◽  
pp. 207 ◽  
Author(s):  
Ramune Jacobsen, MS, MPH ◽  
Per Sjøgren, MD, DMS ◽  
Claus Møldrup, PhD ◽  
Lona Christrup, PhD
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Cancer Pain ◽  
Search Strategy ◽  
Opioid Analgesics ◽  
Drug Prescribing ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Text Word ◽  
Questionnaire Surveys

Objective: The purpose of this review is to summarize the results of studies on physician-related barriers to cancer pain management with opioid analgesics.Methods: A literature search was conducted in PUBMED, using a combined text word and MeSH heading search strategy. Those articles whose full texts were not available in PUBMED were retrieved from the electronic databases of specific journals.Results: Sixty-five relevant articles, published in the period from 1986 to 2006, were identified. Physicians’ barriers to cancer pain management were studied in questionnaire surveys and in the reviews of drug prescribing documents. The results of the articles found were analyzed with respect to (a) knowledge, beliefs, concerns, problems endorsed or acknowledged by physicians treating cancer pain, (b) physicians’ skills in pain assessment, and (c) adequacy of opioid prescription.Conclusions: This review revealed mostly general and common physician-related barriers to cancer pain management: concerns about side effects to opioids, prescription of not efficient doses of opioids, and very poor prescription for the treatment of side effects from opioids. In the future, the evaluation of the influence of cultural-social-economical background, as well as the differences between the various specialists involved in the care of patients with cancer, should be explored to better understand physicians’ barriers and more effectively address them in interventional and educational programs.

scholarly journals Use and patient affordability of opioid analgesics for cancer pain management in different regions of China: a retrospective analysis of data from 2006 to 2016

The Lancet ◽  
2019 ◽  
Vol 394 ◽  
pp. S29
Author(s):  
Zhiran Huang ◽  
Xiawen Su ◽  
Yifan Diao ◽  
Shiyang Liu ◽  
Mengjia Zhi ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Retrospective Analysis ◽  
Opioid Analgesics ◽  
Cancer Pain Management

scholarly journals Pain Intensity as Prognostic Factor in Cancer Pain Management

Pain Practice ◽  
2014 ◽  
Vol 15 (1) ◽  
pp. E1-E8 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Giampiero Porzio ◽  
Claudio Adile ◽  
Federica Aielli ◽  
Andrea Cortegiani ◽  
...  
Keyword(s):  
Pain Management ◽  
Prognostic Factor ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Pain Management

Randomized Clinical Trial of the Effectiveness of a Self-Care Intervention to Improve Cancer Pain Management

2004 ◽  
Vol 22 (9) ◽  
pp. 1713-1720 ◽  
Author(s):  
Christine Miaskowski ◽  
Marylin Dodd ◽  
Claudia West ◽  
Karen Schumacher ◽  
Steven M. Paul ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Management ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Randomized Clinical Trial ◽  
Standard Care ◽  
Psychoeducational Intervention ◽  
Care Group ◽  
Cancer Pain Management ◽  
Standard Care Group

Purpose This randomized clinical trial tested the effectiveness of the PRO-SELF Pain Control Program compared with standard care in decreasing pain intensity scores, increasing appropriate analgesic prescriptions, and increasing analgesic intake in oncology outpatients with pain from bone metastasis. Patients and Methods Patients were randomly assigned to the PRO-SELF intervention (n = 93) or standard care (n = 81). Patients in the standard care arm were seen by a research nurse three times and were called three times by phone between the home visits. PRO-SELF group patients were seen by specially trained intervention nurses and received a psychoeducational intervention, were taught how to use a pillbox, and were given written instructions on how to communicate with their physician about unrelieved pain and the need for changes in their analgesic prescriptions. Patients were coached during two follow-up home visits and three phone calls on how to improve their cancer pain management. Results Pain intensity scores decreased significantly from baseline (all P < .0001) in the PRO-SELF group (ie, least pain, 28.4%; average pain, 32.5%; and worst pain, 27.0%) compared with the standard care group (ie, least increased by 14.6%, average increased by 1.9%, and worst decreased by 1.2%). The percentage of patients in the PRO-SELF group with the most appropriate type of analgesic prescription increased significantly from 28.3% to 37.0% (P = .008) compared with a change from 29.6% to 32.5% in the standard care group. Conclusion The use of a psychoeducational intervention that incorporates nurse coaching within the framework of self-care can improve the management of cancer pain.

scholarly journals Barriers to cancer pain management: A review of empirical research

Medicina ◽  
2009 ◽  
Vol 45 (6) ◽  
pp. 427 ◽  
Author(s):  
Ramunë Jacobsen ◽  
Zita Liubarskienë ◽  
Claus Møldrup ◽  
Lona Christrup ◽  
Per SJøgren ◽  
...  
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Empirical Research ◽  
Health Care System ◽  
Pain Assessment ◽  
Opioid Analgesics ◽  
Cancer Pain Management ◽  
Opioid Prescription ◽  
Care System

Patient-, physician-, and health care system-related barriers of cancer pain management in patients with malignant diseases are a recognized and widely investigated issue. The purpose of this review is to summarize the main findings of empirical research on these barriers in the literature. The most significant patientrelated barriers were patient reluctance to report pain and adhere to treatment recommendations. Besides that, cognitive, affective, and sensory patient-related barriers to cancer pain management with opioid analgesics have been studied using quantitative and qualitative research methods. The Barriers Questionnaire and its shortened and modified versions were the most commonly used instruments in the context of research on patient-related barriers to cancer pain management. The most prominent physicianrelated barriers were insufficient physicians’ knowledge about cancer pain management, inadequate patterns of pain assessment, and inadequate opioid prescription. The methodologies used to conduct the majority of the studies on physician-related barriers were weak. Nevertheless, physician knowledge of pain management guidelines, the quality of pain assessment and opioid prescription have been shown to be obviously better in a few Western countries. Institutional and health care system-related barriers were relevant only in countries with restrictive opioid prescription regulations. The evaluation of the influence of cultural-social-economical background on cancer pain management could probably help to obtain better insight into the problems of unrelieved cancer pain.

Sign in / Sign up

Export Citation Format

Share Document