Practices and Hindrances in Cancer Pain Management: Results of a National Multi-Cancer Center Survey Among Healthcare Professionals in China

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2021 Feb 25

PMID 33628058

Citations 1

Authors

Cuiyun Su

Maojian Chen

Guanxuan Chen

YaJun Li

Ning Li

Zhihuang Hu

Xiao Hu

Yuanyuan Zhao

Qitao Yu

Wei Jiang

Affiliations

Soon will be listed here.

Abstract

Background: Inadequate control of cancer-related pain in China is an ongoing problem. This study investigated the practices of cancer pain (CP) management at major cancer centers in China and perceived hindrances and knowledge of CP management among health professionals.

Methods: From September to October 2019, a survey was conducted using electronic questionnaires via the internet to investigate the practices, and perceived hindrances and knowledge in managing CP among healthcare professionals from 7 provincial cancer centers in China. The questionnaire included demographic data, the professionals' practices among their own patients, their opinions regarding hindrances to CP management, and knowledge of CP management.

Results: We gathered validated responses from 411 anonymous healthcare professionals, with 82.2% (411/500) of response rate. Based on the analysis of these 411 questionnaires, the results demonstrated that CP was prevalent among patients with cancer, while moderate-to-severe pain took a great proportion. CP management was inadequate for a significant proportion of the patients with CP. Pain assessment, analgesic treatment, attention to adverse effects of analgesic, and multidisciplinary management were usually ineffectual in many cases. The duration of work experience did not significantly affect CP management. The respondents considered that both patients and healthcare professionals were responsible for the undermanagement of CP. Only 26 (6.3%) respondents were able to answer correctly all 10 of the professional questions regarding CP.

Conclusion: CP is commonly undermanaged in China. Effective pain control requires the implementation of standards, and the sufficient attention and training of healthcare professionals.

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References

van den Beuken-van Everdingen M, Hochstenbach L, Joosten E, Tjan-Heijnen V, Janssen D . Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis. J Pain Symptom Manage. 2016; 51(6):1070-1090.e9. DOI: 10.1016/j.jpainsymman.2015.12.340. View

Garcia-Mata J, Alamo C, de Castro J, Contreras J, Galvez R, Jara C . A survey of perceptions, attitudes, knowledge and practices of medical oncologists about cancer pain management in Spain. Clin Transl Oncol. 2018; 20(8):1061-1071. DOI: 10.1007/s12094-017-1826-8. View

Greco M, Roberto A, Corli O, Deandrea S, Bandieri E, Cavuto S . Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol. 2014; 32(36):4149-54. DOI: 10.1200/JCO.2014.56.0383. View

Ventafridda V, Tamburini M, Caraceni A, De Conno F, NALDI F . A validation study of the WHO method for cancer pain relief. Cancer. 1987; 59(4):850-6. DOI: 10.1002/1097-0142(19870215)59:4<850::aid-cncr2820590432>3.0.co;2-1. View

Gunnarsdottir S, Sigurdardottir V, Kloke M, Radbruch L, Sabatowski R, Kaasa S . A multicenter study of attitudinal barriers to cancer pain management. Support Care Cancer. 2017; 25(11):3595-3602. DOI: 10.1007/s00520-017-3791-8. View

Breuer B, Fleishman S, Cruciani R, Portenoy R . Medical oncologists' attitudes and practice in cancer pain management: a national survey. J Clin Oncol. 2011; 29(36):4769-75. DOI: 10.1200/JCO.2011.35.0561. View

Marinangeli F, Ciccozzi A, Leonardis M, Aloisio L, Mazzei A, Paladini A . Use of strong opioids in advanced cancer pain: a randomized trial. J Pain Symptom Manage. 2004; 27(5):409-16. DOI: 10.1016/j.jpainsymman.2003.10.006. View

Berterame S, Erthal J, Thomas J, Fellner S, Vosse B, Clare P . Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study. Lancet. 2016; 387(10028):1644-56. DOI: 10.1016/S0140-6736(16)00161-6. View

Silvoniemi M, Vasankari T, Vahlberg T, Vuorinen E, Clemens K, Salminen E . Physicians' self-assessment of cancer pain treatment skills--more training required. Support Care Cancer. 2012; 20(11):2747-53. DOI: 10.1007/s00520-012-1396-9. View

10.

Liu Z, Lian Z, Zhou W, Mu Y, Lu X, Zhao D . National survey on prevalence of cancer pain. Chin Med Sci J. 2003; 16(3):175-8. View

11.

Wiffen P, Wee B, Derry S, Bell R, Moore R . Opioids for cancer pain - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2017; 7:CD012592. PMC: 6483487. DOI: 10.1002/14651858.CD012592.pub2. View

12.

Chapman E, Edwards Z, Boland J, Maddocks M, Fettes L, Malia C . Practice review: Evidence-based and effective management of pain in patients with advanced cancer. Palliat Med. 2020; 34(4):444-453. DOI: 10.1177/0269216319896955. View

13.

Scarborough B, Smith C . Optimal pain management for patients with cancer in the modern era. CA Cancer J Clin. 2018; 68(3):182-196. PMC: 5980731. DOI: 10.3322/caac.21453. View

14.

Corli O, Floriani I, Roberto A, Montanari M, Galli F, Greco M . Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV 'real life' trial on the variability of response to opioids. Ann Oncol. 2016; 27(6):1107-1115. DOI: 10.1093/annonc/mdw097. View

15.

van den Beuken-van Everdingen M, de Rijke J, Kessels A, Schouten H, van Kleef M, Patijn J . High prevalence of pain in patients with cancer in a large population-based study in The Netherlands. Pain. 2007; 132(3):312-320. DOI: 10.1016/j.pain.2007.08.022. View

16.

Xia Z . Cancer pain management in China: current status and practice implications based on the ACHEON survey. J Pain Res. 2017; 10:1943-1952. PMC: 5571848. DOI: 10.2147/JPR.S128533. View

17.

Sanford N, Sher D, Butler S, Xu X, Ahn C, Aizer A . Prevalence of chronic pain among cancer survivors in the United States, 2010-2017. Cancer. 2019; 125(23):4310-4318. DOI: 10.1002/cncr.32450. View

18.

Bandieri E, Romero M, Ripamonti C, Artioli F, Sichetti D, Fanizza C . Randomized Trial of Low-Dose Morphine Versus Weak Opioids in Moderate Cancer Pain. J Clin Oncol. 2015; 34(5):436-42. DOI: 10.1200/JCO.2015.61.0733. View

19.

Jho H, Kim Y, Kong K, Kim D, Nam E, Choi J . Knowledge, practices, and perceived barriers regarding cancer pain management among physicians and nurses in Korea: a nationwide multicenter survey. PLoS One. 2014; 9(8):e105900. PMC: 4140841. DOI: 10.1371/journal.pone.0105900. View

20.

Kwon J . Overcoming barriers in cancer pain management. J Clin Oncol. 2014; 32(16):1727-33. DOI: 10.1200/JCO.2013.52.4827. View