A physician's practice, attitude and approach for the management of palliative care for cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 112-112
Author(s):  
Shijian Feng ◽  
Qiongwen Zhang ◽  
Chunhua Yu ◽  
Huashan Shi ◽  
Wenxiu Yao ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Professional Education ◽  
Physician Education ◽  
Dose Titration ◽  
Categorical Variables ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Knowledge Of Cancer ◽  
Chi Square Analysis

112 Background: Pain is the most frequent and persistent symptom experienced by cancer patients. Thus, exploring how to achieve the best outcome of cancer pain management in China is clearly extremely important. Our study focuses on the Chinese physicians' current clinical practice, attitudes, toward and barriers to opioid use, and knowledge of cancer pain management. Methods: A face to face survey include 23 items was designed and conducted to the doctors working with cancer pain managements (oncologists, internists, hematologists, et al) responsible for the care of patients with cancer in 11 tertiary hospitals in China. Descriptive statistics were used to characterize the total sample and for multiple choice questions and each item. Chi-square analysis was used to examine the difference between categorical variables. Results: 500 questionnaires were received out of 550. Most (62.2%) physicians assessed patients’ cancer pain every day, but 85.5% never or occasionally treated patients’ cancer pain together with psychologists. Most respondents appreciated that > 50% of patients with cancer experience severe chronic pain warranting analgesic therapy (73.5%), and that this therapy could control pain adequately in > 50% of patients (77.2%). More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. A majority (65.0%) of physicians responded incorrectly (60.0% agreed and 5.0% had no opinion) that they would increase the dosage of a potent opioid and administer it every 4 h as needed (q4h PRN). Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently barriers to physicians’ pain management. Conclusions: Our results revealed that physician education in cancer pain management in China does not currently provide the necessary levels of knowledge and skills. Therefore, effective strategies and professional education are still needed to encourage physicians’ concern with, experience in, and knowledge of cancer pain management in China.

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]

Opioid Rotation for Toxicity Reduction (DRAFT)

2018 ◽  
Author(s):  
Anna Cecilia Tenorio ◽  
Akhila Reddy
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Clinical Case ◽  
Cancer Pain Management ◽  
Opioid Rotation ◽  
Patients With Cancer ◽  
Daily Dose ◽  
Study Intervention ◽  
Morphine Equivalent

This chapter discusses the de Stoutz et al. retrospective review of patients with cancer pain who developed dose-limiting toxicities and underwent opioid rotation that resulted in improvement of symptoms related to opioid induced neurotoxicity, uncontrolled pain, and reduction in morphine equivalent daily dose. This study is the first to establish that opioid rotation, which is substituting one opioid with another using established equianalgesic conversion ratios, is a valuable tool in cancer pain management. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

Interventional Therapies for Cancer Pain Management: Important Adjuvants to Systemic Analgesics

2007 ◽  
Vol 5 (8) ◽  
pp. 851-858 ◽  
Author(s):  
Anthony Eidelman ◽  
Traci White ◽  
Robert A. Swarm
Keyword(s):  
Pain Management ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Pain Control ◽  
Analgesic Efficacy ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Inflammatory Drugs ◽  
Control Pain ◽  
Interventional Therapies

Optimized use of systemic analgesics fails to adequately control pain in some patients with cancer. Commonly used analgesics, including opioids, nonopioids (acetaminophen and non-steroidal anti-inflammatory drugs), and adjuvant analgesics (anticonvulsants and antidepressants), have limited analgesic efficacy, and their use is often associated with adverse effects. Without adequate pain control, patients with cancer not only experience the anguish of poorly controlled pain but also have greatly diminished quality of life and may even have reduced life expectancy. Interventional pain therapies are a diverse set of procedural techniques for controlling pain that may be useful when systemic analgesics fail to provide adequate control of cancer pain or when the adverse effects of systemic analgesics cannot be managed reasonably. Commonly used interventional therapies for cancer pain include neurolytic neural blockade, spinal administration of analgesics, and vertebroplasty. Compared with systemic analgesics, which generally have broad indications for control of pain, individual interventional therapies generally have specific, narrow indications. When appropriately selected and implemented, interventional pain therapies are important components of broad, multimodal cancer pain management that significantly increases the proportion of patients able to experience adequate pain control.

Analysis of the patient-related barriers in cancer pain anagement in Turkish patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20699-e20699
Author(s):  
G. Bagçivan ◽  
N. Tosun ◽  
S. Kömürcü ◽  
A. Özet ◽  
N. Akbayrak
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Brief Pain Inventory ◽  
Cancer Pain Management ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Demographic Questionnaire ◽  
Average Pain ◽  
Turkish Patients ◽  
Reliable Scale

e20699 Background: The most important issue, which may be preventing effective cancer pain management, have generally been the barriers originating from misbelieve or misunderstandings, which lead patients to be reluctant to report pain and receive the appropriate analgesic. It is the first study about this issue in Turkey. Methods: This study was planned as a descriptive and cross-sectional. The sample was 170 patients with cancer, who used or is still using analgesic medication for pain related to cancer. Demographic Questionnaire, Brief Pain Inventory and BQ-II were used for data collection. The reliability coefficient for the total scale and subscales (Cronbach's α) were calculated. Test and retest results were compared to determine the scales validity for Turkish patients. All statistical analyses were performed with the SPSS 15.0.The value p≤0.05 was considered ‘statistically significant’. Results: As a result of the factor analysis made for BQ-II, seven factors that make up for 66.451% of the total variance were found. Cronbach's alpha value was 0.87 for the BQ-II. According to the points given by patients to the items in BQ-II, it was seen that they have beliefs that may be barriers to optimal pain management mostly in “addiction” and minimally in “physical side effects” subscale. It was ascertained that male, not married patients, patients with a chronic disease other than cancer, patients whose “average pain” level is >5 and who use inadequate analgesic have more beliefs that may be barriers to optimal pain management. Conclusions: BQ-II was a valid and reliable scale for Turkish defining patient related barriers in cancer pain management. Items suggested by patients such as “family related barriers” and “family members’ role and responsibilities” could be added to the BQ-II for future studies. No significant financial relationships to disclose.

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 The Pro-Self© Pain Control Program Improves Patients' Knowledge of Cancer Pain Management

2012 ◽  
Vol 44 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Tone Rustøen ◽  
Berit Taraldsen Valeberg ◽  
Eva Kolstad ◽  
Erik Wist ◽  
Steven Paul ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Control ◽  
Control Program ◽  
Cancer Pain Management ◽  
Knowledge Of Cancer

scholarly journals A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians

2004 ◽  
Vol 9 (4) ◽  
pp. 188-194 ◽  
Author(s):  
R Gallagher ◽  
P Hawley ◽  
W Yeomans
Keyword(s):  
British Columbia ◽  
Pain Management ◽  
Cancer Pain ◽  
Knowledge Score ◽  
Basic Knowledge ◽  
Physician Education ◽  
Prescribing Practices ◽  
Cancer Pain Management ◽  
Opioid Prescribing ◽  
Significant Difference

INTRODUCTION:There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS:A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Physicians and Surgeons of British Columbia regulation and other issues related to their prescribing practices, and assessed basic knowledge of cancer pain management.RESULTS:There was a 69% return rate with a total of 4618 evaluable responses. There was a significant difference among medical disciplines, years in practice, number of chronic pain patients seen and size of community of practice. The highest knowledge scores were achieved by oncologists and the lowest scores were from surgeons. Those who practiced in smaller communities had a higher average knowledge score. Those who felt their knowledge about cancer pain was inadequate scored lower than those who felt their knowledge was adequate. The questions most frequently answered incorrectly (or by 'don't know') were those about equianalgesic dosing (68%) and adequate breakthrough dosing (45%), revealing knowledge deficiencies that would significantly impair a physician's ability to manage cancer pain.CONCLUSIONS:The details of opioid prescribing are crucial areas to target education for cancer pain management. The surveyed physicians accepted the need for regulation of opioid prescribing with very few being fearful of scrutiny from the College of Physicians and Surgeons of British Columbia. However, the inconvenience of the triplicate prescription pad was more of a barrier to prescribing, it being of concern to 20% of respondents, particularly surgeons and medical specialists.

The PRO-SELF® Pain Control Program Improves Patients' Knowledge of Cancer Pain Management

2004 ◽  
Vol 31 (6) ◽  
pp. 1137-1143 ◽  
Author(s):  
Jung-Eun Kim ◽  
Marylin Dodd ◽  
Claudia West ◽  
Steven Paul ◽  
Noreen Facione ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Control ◽  
Control Program ◽  
Cancer Pain Management ◽  
Knowledge Of Cancer
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