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 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.

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.

scholarly journals Episodic Cancer Pain: Patient Reporting, Prevalence, and Clinicodemographic Associations at Initial Cancer Pain Clinic Assessment

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Paulo Reis-Pina ◽  
Anand Acharya ◽  
Antonio Barbosa ◽  
Peter G. Lawlor
Keyword(s):  
Cancer Pain ◽  
Pain Intensity ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Pain Clinic ◽  
Pain Patient ◽  
Cross Sectional ◽  
Pain Location ◽  
Patient Reported ◽  
Average Pain

Background. Better understanding of the episodic cancer pain (CP) spectrum, including pains that occur in addition to its conventionally defined breakthrough CP (BTcP) and incident CP (IcP) components, may inform CP assessment and management. This study aimed to determine the prevalence of episodic patient-reported CP and the prevalence and associations of study-defined BTcP (S-BTcP) and IcP (S-IcP) in patients with CP. Methods. In a cross-sectional study at their first CP clinic attendance, participants with CP had the following assessments: Brief Pain Inventory (BPI); Pain Management Index (PMI), with PMI-negative status indicating undertreatment; standardized neuropathic pain component (NPC) status; S-BTcP (no trigger identified) and S-IcP (trigger identified) status, based on a preceding 7-day history of transitory pain flares distinct from background pain, and BPI-Worst or BPI-Now pain intensity ≥ 4. Clinicodemographic variables’ association with S-BTcP and S-IcP was examined in logistic regression analyses. Results. Of 371 participants, 308 (83%) had episodic CP by history alone; 140 (37.7%) and 181 (48.8%) had S-BTcP and S-IcP, respectively. Multivariable analyses demonstrated significant (p<0.05) associations (odds ratios: 95% CIs) for 6 variables with S-BTcP: head and neck pain location (2.53; 1.20–5.37), NPC (2.39; 1.34–4.26), BPI average pain (1.64; 1.36–1.99), abdominal pain (0.324; 0.120–0.873), S-IcP (0.207; 0.116–0.369), and PMI-negative status (0.443; 0.213–0.918). Similar independent associations (p<0.05) occurred for S-IcP with NPC, BPI average pain, and PMI-negative status, in addition to radiotherapy, S-BTcP, soft tissue pain, and sleep interference. Conclusions. Episodic or transient patient-reported CP flares often do not meet the more conventional criteria that define BTcP and IcP, the principal episodic CP types. Both BTcP and IcP occur frequently and both are associated with a NPC, higher pain intensity, and less opioid underuse in the management of CP. Further studies are warranted to both better understand the complex presentations of episodic CP and inform its classification.

scholarly journals Evaluation of oral drug adherence in patients with oncological pain in Pernambuco reference hospital

2020 ◽  
Vol 11 (2) ◽  
pp. 0474
Author(s):  
Dayseanne B. SILVA ◽  
Juvanier R. CRUZ ◽  
Narcisa C. SILVA
Keyword(s):  
Cancer Pain ◽  
Family Income ◽  
Cross Sectional Study ◽  
Oral Drug ◽  
Drug Adherence ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
High Incidence ◽  
Reference Hospital ◽  
Socioeconomic Profile

Objectives: The aim of this study was to describe the profile of patients with cancer pain using oral opioids, to evaluate the therapeutic adherence of these patients and to identify the factors associated with it. Methods: It was a cross-sectional study carried out at the Pharmacy of the Hospital de Câncer de Pernambuco, from March to September 2019. Each patient were selected for convenience and were interviewed once, and the Medicines Evaluation Questionnaire (BMQ) was used to determine adherence and FACS for determine the socioeconomic, demographic and clinical profile. The data was analyzed using the Statistical Package for Social Sciences (SPSS) program. Results: In total, 46 patients were interviewed, aged between 19 and 82 years, 59% did not have complete elementary school, 74% had family income equal or less than 1 minimum wage and 71% classified as non-adherent, with the domain “recall screen” the most scored (84%). Patients using controlled-release medications (p = 0.0000352) and with higher levels of education (p = 0.016) obtain better adherence results in the BMQ questionnaire. Conclusions: Through the study it was possible to identify a high incidence of patients not adhering to drug therapy and their socioeconomic profile, highlighting the need for political and institutional interventions. Due to the scarcity of publications, further studies are needed to determine adherence factors in patients with cancer pain.

scholarly journals Factors related to pain management adequacy in patients receiving palliative care: data from a tertiary hospital in Indonesia

2020 ◽  
Vol 29 (4) ◽  
pp. 399-402
Author(s):  
Hamzah Shatri ◽  
Ratih Arianita Agung ◽  
Vera Abdullah ◽  
Dina Elita ◽  
Rudi Putranto ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Pain Intensity ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Opioid Use ◽  
Cross Sectional ◽  
Pain Management Index ◽  
Adequate Pain Management

BACKGROUND Adequate pain management must be applied to improve the quality of life, particularly in patients receiving palliative care. Thus, this study aimed to determine the factors related to pain management adequacy in patients receiving palliative care. METHODS This cross-sectional study included all patients sent for consultation to the palliative care team complaining of pain in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from 2016 to 2018. All data such as gender, age, employment status, disease type, primary cancer location, pain intensity, analgesic drug treatment duration, and the presence of anxiety and depression were retrieved from medical records. Pain management adequacy was evaluated using the pain management index. Logistic regression included all variables with p<0.25 related to pain management adequacyin bivariate analysis. RESULTS Out of 175 patients with pain, 85.7% reported having adequate pain management. Pain was more adequately treated in patients with employment (p = 0.001), milder pain intensity (p<0.001), those using opioids (p<0.001), and those who did not experience anxiety (p = 0.05). Factors related to pain management adequacy were opioid use (OR = 3.23, 95% CI = 1.71–6.13) and milder pain (OR = 11.15, 95% CI = 3.89–31.99). CONCLUSIONS Most of the patients received adequate pain management which related to opioid use and milder pain.

scholarly journals Adequacy of Cancer-Related Pain Treatments and Factors Affecting Proper Management in Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kald Beshir Tuem ◽  
Leake Gebremeskel ◽  
Kibrom Hiluf ◽  
Kbrom Arko ◽  
Haftom Gebregergs Hailu
Keyword(s):  
Pain Management ◽  
Assessment Tool ◽  
Negative Impact ◽  
Short Form ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Strong Opioids

Background. Cancer-related pain (CRP) is a major problem with a potential negative impact on quality of life of the patients and their caregivers. Purpose. To assess the adequacy of cancer-related pain management in Ayder Comprehensive Specialized Hospital (ACSH). Methodology. A facility-based cross-sectional study design was conducted in ACSH from January to March 2019. A well-structured professional-assisted questionnaire using Brief Pain Inventory-Short Form (BPI-SF) was used to collect data concerning the severity of pain, functioning interference, and adequacy of pain management in cancer patients. Data were analyzed using SPSS v.21. Result. Out of 91 participants, 47 (51.6%) were male and 52 (57.1%) were between the age group of 18–45, with the mean age of 44.8 ± 13.6 years. According to the pain assessment tool (BPI), 85 (93.4%) patients experienced pain and 90 (98.9%) patients had activity interference; negative pain management index (PMI) was observed in 40 (43.95%) patients, showing that 43.95% were receiving inadequate pain management. Out of 38 patients who received no analgesics, 35.2% were found to have inadequate pain management, whereas those who took strong opioids had 100% effective pain management and the majority of the patients were in stage III. Among 38 (41.76%) only 20 (52.63%) received adequate pain management, based on patients’ self-report in which 18.7% of the participants stated that they got 30% pain relief and only 1.1% got 90% relief. The predictors of undertreatment were presence of severe pain, metastasis, comorbidity, and stage of the cancer and could also be due to the educational level and monthly income, as evidenced by significant association. Conclusion. This study suggests that cancer pain management in ACSH was sufficient for only 56%. However, large numbers of individuals are suffering from a manageable pain. Hence, remedial action should be taken, including increasing awareness of symptom management in medical staff and incorporating existing knowledge into routine clinical practice.

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 A multicentre survey of pain management in cancer patients and physicians attending radiotherapy clinics in Shandong Province, China

2019 ◽  
Vol 47 (11) ◽  
pp. 5711-5722
Author(s):  
Bingxu Tan ◽  
Baosheng Li ◽  
Yongheng An ◽  
Xuezhen Ma ◽  
Yuhua Jiang ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Treatment ◽  
Cross Sectional Study ◽  
Shandong Province ◽  
Cross Sectional ◽  
Waiting Period ◽  
Face To Face ◽  
Significant Difference ◽  
High Incidence ◽  
Prevalence Of Pain

Objective To obtain a better understanding of the prevalence and management of pain in patients undergoing radiotherapy for cancer in Shandong Province, China. Methods This cross-sectional study used a questionnaire during face-to-face interviews to collect data from physicians and patients regarding the recognition, prevalence and treatment of pain during the waiting period before commencement of radiotherapy and during the radiotherapy period. Physicians and patients were recruited from 10 tertiary Class A hospitals across Shandong Province, China. Results A total of 184 patients and 87 physicians were recruited to the study. During the waiting period, pain was reported by the physicians according to their experience to affect 26.0% of patients, which almost agreed with the patients’ data (36.5%; 160 of 438). During the radiotherapy period, there was a significant difference in the reported prevalence of pain during the radiotherapy period between the physicians’ data (23.0%) based on their experience and the patients’ data (84.1%; 169 of 201 patients). The majority of physicians (98.9%; 86 of 87) agreed to the use opioids for pain management and 90.8% (79 of 87) were satisfied with the analgesic effect, but more than half of the patients who received pain treatment reported inadequate analgesia. Conclusion There was a high incidence of cancer pain, but insufficient assessment, inadequate treatment and inadequate education about pain in both the waiting and radiotherapy periods.

scholarly journals Validation of the Japanese version of the barriers questionnaire II in cancer pain management: a cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoki Sakakibara ◽  
Hiroko Komatsu ◽  
Mikako Takahashi ◽  
Hideko Yamauchi ◽  
Teruo Yamauchi ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Japanese Version ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cancer Pain Management ◽  
Cross Sectional

scholarly journals Levels of physical activity in people with chronic pain

2017 ◽  
Vol 73 (1) ◽  
Author(s):  
Romy Parker ◽  
Emma Bergman ◽  
Anelisiwe Mntambo ◽  
Shannon Stubbs ◽  
Matthew Wills
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Pain Management ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Control Group ◽  
Chronic Pain Management ◽  
Pain Group ◽  
Cross Sectional ◽  
Management Intervention

Background: People who suffer from chronic pain are thought to have lower levels of physical activity compared to healthy individuals. However, there is a lack of evidence concerning levels of physical activity in South Africans with chronic pain. Objectives: To compare levels of physical activity in a South African sample of people with chronic pain compared to matched controls. Methods: A cross-sectional study was conducted with 24 participants (12 with chronic pain and 12 in the control group matched for age, gender and residential area). Convenience sampling was used. The participants with chronic pain (12) were identified from the Groote Schuur Hospital, Chronic Pain Management Clinic (CPMC) waiting list and had not yet received any chronic pain management intervention. Healthy matched controls were selected from volunteers in the community. With the desired alpha level set at 0.05 and the power at 0.9, 45 participants were required to detect a minimum of a 50 per cent difference between groups in levels of physical activity as measured in steps per day using pedometers. The international physical activity questionnaire (IPAQ) and the brief pain inventory (BPI) were used as measures of physical activity and pain. Objective indicators of physical activity that were used included the 6-minute walk test (6MWT), repeated sit-to-stand test (RSST), 7 days of pedometry and body mass index (BMI). Results: The chronic pain group performed significantly worse on the 6MWT (335 m [30–430] vs 680 m [430–795]; U = 0.5; p < 0.01) and on the RSST (17.9 s [11.83–105] vs 7.85 s [5.5–11.5]; U = 0; p < 0.01). The chronic pain group also had significantly lower scores on pedometry (mean daily: 2985.1 [32.8–13785.4] vs 6409.4 [4207.1–15313.6]; U = 35; p < 0.03). The BMI for the chronic pain group was significantly higher than matched controls (29.36 kg/m2 [18.94–34.63] vs 22.16 kg/m2 [17.1–30.86]; U = 34; p < 0.03). Conclusion: Participants with chronic pain had a reduced capacity for physical activity. The pedometry results illustrate a range of maladaptive strategies adopted by those with chronic pain. The majority of people with chronic pain appear to avoid physical activity leading to greater disability as a result of immobility and muscle atrophy. However, a small subgroup appears to ignore their pain and push themselves physically despite their pain. This perseverance behaviour leads to further pain as a consequence of muscle and joint overuse. Both maladaptive behavioural responses result in further sensitisation of the central nervous system. The method used to target physical activity in these patients should be considered in treatment planning, specifically for physiotherapy.

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