Quality of Cancer Pain Management: An Update of a Systematic Review of Undertreatment of Patients With Cancer

2014 ◽  
Vol 32 (36) ◽  
pp. 4149-4154 ◽  
Author(s):  
Maria Teresa Greco ◽  
Anna Roberto ◽  
Oscar Corli ◽  
Silvia Deandrea ◽  
Elena Bandieri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Cancer Pain ◽  
Experimental Studies ◽  
Sensitivity Analyses ◽  
Substantial Impact ◽  
Patients With Cancer ◽  
Pain Management Index ◽  
Before And After

Purpose Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent. Methods We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4% of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses. Results In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25% (from 43.4 to 31.8%). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.

scholarly journals Acupuncture for palliative cancer pain management: systematic review

2021 ◽  
pp. bmjspcare-2020-002638
Author(s):  
Juan Yang ◽  
Dietlind L Wahner-Roedler ◽  
Xuan Zhou ◽  
Lesley A Johnson ◽  
Alex Do ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Included Study ◽  
Favourable Effect ◽  
Levels Of Evidence ◽  
Patients With Cancer ◽  
Level 3 ◽  
Randomised Controlled

BackgroundPain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care.ObjectiveTo critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings.MethodsMultiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence.ResultsFive studies (n=189) were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings.ConclusionsAcupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality, adequately powered studies are needed in the future.

Pain management

2020 ◽  
pp. 629-633
Author(s):  
Marie Fallon
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Daily Functioning ◽  
Opioid Analgesia ◽  
Patients With Cancer ◽  
Good Pain Relief

Pain occurs in more than 50% of patients with advanced disease, interferes with daily functioning and quality of life, and is very often undertreated. Patients can find it difficult to articulate the character of their pains, but it is important to determine whether it is somatic, neuropathic, or visceral since this has important implications for management. For most patients with cancer pain, a three-step approach combining simple or opioid analgesia (depending on severity) along with an adjuvant analgesic (depending on cause) will result in good pain relief, but the challenge is to achieve good pain relief without unacceptable adverse effects.

scholarly journals Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India

2018 ◽  
pp. 1-9
Author(s):  
Katherine E. Doyle ◽  
Shatha K. El Nakib ◽  
M.R. Rajagopal ◽  
Sunil Babu ◽  
Geeta Joshi ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Survey Tool ◽  
Patients With Cancer ◽  
Pain Management Index ◽  
Indian Patients ◽  
Prevalence Of Pain

Purpose More than 1 million new occurrences of cancer are diagnosed in India annually. Among patients with cancer, pain is a common and persistent symptom of the disease and its treatment. However, few studies to date have evaluated the prevalence of pain and the adequacy of pain management in Indian hospitals. This cross-sectional study aimed to assess the prevalence and sociodemographic patterns of cancer pain and pain management among a sample of inpatients and newly registered outpatients at four large regional cancer centers in India. Methods A sample of 1,600 patients with cancer who were current inpatients or newly registered outpatients were recruited and administered a questionnaire that was based on the Brief Pain Inventory. The survey tool included questions on demographics, medical history, and extent of clinical pain experienced. In addition, a pain management index score was created to link the severity of cancer pain with medication prescribed to treat it. Results A total of 88% of patients reported pain in the past 7 days, and approximately 60% reported that their worst pain was severe. Several demographic and medical characteristics of the study population predicted severe pain, including the following: lower educational level, outpatient status, and debt incurred as a result of illness. A total of 67% of patients were inadequately treated with analgesics. Inadequate pain management was associated with both treatment hospital and patient type, and patients who reported debt as a result of their illness were more likely to have inadequate pain management. Conclusion A majority of Indian patients with cancer experience significant pain and receive inadequate pain management. Improvement of pain management for Indian patients with cancer is needed urgently.

scholarly journals EVALUATION OF THE QUALITY OF PAIN MANAGEMENT IN CANCER PATIENTS: STUDY OF 60 MOROCCAN PATIENTS AND LITERATURE REVIEW

2021 ◽  
Vol 9 (10) ◽  
pp. 217-224
Author(s):  
Naoufal Assoufi ◽  
◽  
Mohammed Ajamat ◽  
Bourazza Ahmed Jamal Fatihi ◽  
Fadwa Mekouar ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Global Strategy ◽  
Pain Management Index ◽  
Lack Of Information ◽  
Verbal Scale ◽  
Need To Evaluate ◽  
A Prospective Study

Cancer is a chronic disease that affects patients quality of life, hence the need to evaluate the quality of care in its globality without forgetting cancer pain. This study aims to acknowledge the pain in cancer patients, evaluate it using international scales, and see to what extent this pain is managed in its totality. This is a prospective study to evaluate the quality of cancer pain management, 60 patients were included, 26 women and 34 men, with an average age of 52.2 years. The evaluation of pain concerned different cancer pathologies, according to the simple verbal scale and the visual analog scale, the majority of our patients (83.4%) had pain, 68.4% had moderate to severe pain, the use of level III analgesics occurred in 35% of patients. Among our sample 37% of cancer patients had negative pain management index scores, indicating inadequate analgesic treatment. This study shows that the management of cancer pain is still insufficient for reasons of organization and lack of information. This situation cannot be improved without the establishment of a global strategy for the management of cancer pain.

Assessment of adequacy of pain management in advance cancer patients.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. e283-e287
Author(s):  
Harminder Singh ◽  
Raja Banipal
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Dose Titration ◽  
Cancer Type ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Pain Management Index ◽  
Cancer Types ◽  
New Formulation

e283 Background: Cancer prevalence in India is estimated around 2.0-2.5 million, 0.7- 0.8 million new cases identified every year, and cancer deaths reported per year is 0.4-0.5 Million. The objective of this study was to estimation of the prevalence of inadequate cancer pain management in patients with advanced cancer. Methods: Adequacy of pain management, that is Pain Management Index calculated for each patient. It is simple indexes which usually indicate a connection of the reported level of pain to the potency of the analgesics prescribed Results: 211 patients were recruited with most prevalent cancer type was genitourinary, diagnosed in 28.7% patients, followed by breast cancer 23.1% and head & neck cancer 20.3%. Among 211 patients with cancer, 76.85% patients had inadequate pain management and 23.14% had better control of pain. Association of inadequacy of pain were done with age, gender, occupation, family history, duration and cancer types, signification relation was observed with age group and analgesic use. (See table.) Conclusions: Our inadequate pain management prevalence rate of about 78% was far too high so this study will highlight the importance of true status of cancer pain management. It also emphasized that systematic recording of pain intensity and follow up further enhance the entire pain management mechanism including dose titration to change of new formulation. [Table: see text]

scholarly journals Assessment of Adequacy of Pain Management and Analgesic Use in Patients With Advanced Cancer Using the Brief Pain Inventory and Pain Management Index Calculation

2017 ◽  
Vol 3 (3) ◽  
pp. 235-241 ◽  
Author(s):  
Harminder Singh ◽  
Raja Paramjeet Singh Banipal ◽  
Baltej Singh
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Age Groups ◽  
Brief Pain Inventory ◽  
Cancer Type ◽  
Cancer Pain Management ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Pain Management Index ◽  
Pain Symptoms

Purpose The objective of this cross-sectional, noninterventional, 6-month observational study was to assess the adequacy of pain management in patients with cancer admitted to the Oncology Department of Guru Gobind Singh Medical College in Faridkot, India. Methods and Materials A total of 348 patients with cancer were recruited for evaluation of the prevalence of inadequate cancer pain management using the Brief Pain Inventory Pain Management Index. Results The current study included 127 males (36.5%) and 221 females (63.5%). The most prevalent cancer type was genitourinary; 268 patients (77%) had inadequately managed pain. A significant correlation was observed between poorly managed pain and age groups, analgesic used, and body mass index. Conclusion Our observation of inadequate pain management among 77% of patients indicates that pain management was insufficient in three quarters of the patients in this study. Accumulating data regarding the inadequacy of cancer pain management is crucial to improve symptom management. Better management of pain not only alleviates pain symptoms but also increases the quality of life for patients with cancer.

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