title: Pain control in ambulatory cancer patients--can we do better?
abstract: To evaluate the degree of pain control among ambulatory cancer patients visiting the outpatient clinics of three oncology centers in south Israel, these patients were interviewed using the Brief Pain Inventory translated into Hebrew (BPI-Heb). Patients suffering from pain at least three times a week or reporting taking daily analgesics during the last two weeks were enrolled. Non-Hebrew speakers and patients too frail or ill were excluded. The study population included 218 subjects. Substantial pain was experienced by 77%, the majority was not adequately treated (81%), and 75% were undermedicated. The daily living activities of the majority of patients (64%) were moderately to severely impacted. Pain control was not associated with any of the sociodemographic or previous treatment profile variables, or by physicians' pain assessment. The physicians' and the patients' ratings of the extent to which pain interfered with the patients' activities fully agreed (+/-2) in fewer than half of the patients. Physicians estimated more severe pain levels, but underestimated its impact on everyday life. These data indicate that better pain control for ambulatory cancer patients is needed and that more information about patients' pain and its impact should be solicited. Further training of care providers is needed to improve the relief from cancer pain and the quality of life of patients.
authors.affiliation: Palliative Medicine Unit, Family Medicine Department and Sial Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Pesach
authors.initials: P
authors.lastname: Shvartzman
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.forename: Adi
authors.initials: A
authors.lastname: Shani
authors.forename: Frida
authors.initials: F
authors.lastname: Barak
authors.forename: Cohen
authors.initials: C
authors.lastname: Yoram
authors.forename: Yoram
authors.initials: Y
authors.lastname: Singer
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D011787:Quality of Health Care