Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries.
In order to implement more effective policies for cancer pain management, a better understanding of current practices is needed. Physicians managing cancer pain and patients experiencing cancer pain were randomly surveyed across 10 Asian countries to assess attitudes and perceptions toward cancer pain management. A total of 463 physicians (77.3% oncologists) with a median experience of 13 years were included. Medical school training on opioid use was considered inadequate by 30.5% of physicians and 55.9% indicated ≤ 10 h of continuing medical education (CME). Of the 1190 patients included, 1026 reported moderate-to-severe pain (median duration, 12 months). Discordance was observed between physician and patient outcomes on pain assessment with 88.3% of physicians reporting pain quantification, while 49.5% of patients claimed that no scale was used. Inadequate assessment of pain was recognized as a barrier to therapy optimization by 49.7% of physicians. Additional barriers identified were patients' reluctance owing to fear of addiction (67.2%) and adverse events (65.0%), patients' reluctance to report pain (52.5%), excessive regulations (48.0%) and reluctance to prescribe opioids (42.8%). Opioid use was confirmed only in 53.2% (286/538) of patients remembering their medication. Pain affected the activities of daily living for 81.3% of patients. These findings highlight the need for better training and CME opportunities for cancer pain management in Asia. Collaborative efforts between physicians, patients, policy makers, and related parties may assist in overcoming the barriers identified. Addressing the opioid stigma and enhancing awareness is vital to improving current standards of patient care.
Department of Anesthesiology and Pain Medicine, Seoul National University School of Medicine, Seoul, Korea.
Yong-Chul
YC
Kim
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jin Seok
JS
Ahn
Departments of Pharmacology, Clinical Epidemiology and Anesthesiology, University of Santo Tomas Faculty of Medicine and Surgery and the UST Hospital, Manila, Philippines.
Maria Minerva P
MM
Calimag
Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, China.|Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, China.
Ta Chung
TC
Chao
Pain Management Service, Raffles Hospital, Singapore, Singapore.
Kok Yuen
KY
Ho
Department of Clinical Oncology, Beacon International Specialist Centre, Selangor, Malaysia.
Lye Mun
LM
Tho
Sun Yat-Sen University Cancer Center, Guangzhou, China.
Zhong-Jun
ZJ
Xia
Mundipharma Research Ltd, Cambridge, United Kingdom.
Lois
L
Ward
Mundipharma Pte Ltd, Singapore, Singapore.
Hanlim
H
Moon
Mundipharma Pte Ltd, Singapore, Singapore.
Abhishek
A
Bhagat
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D059408:Pain Management; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
Cancer pain; pain management survey