Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey.
This study sought to explore the association between physician practice patterns and patient education, with a focus on breakthrough cancer pain (BTcP). A nationwide online survey was conducted by 92 Korean physicians. Thirteen questions on Korean physician's assessment, prescription, patient education practices, and knowledge regarding BTcP were administered. Based on their responses, physicians were divided using two methods: (1) by their patient education practices, where the "education group" always explained the distinction between background pain and BTcP and the "less education group" which explained it less frequently; and (2) by their definition of BTcP, as occurring "after control of background pain" or "regardless of background pain." We compared practice patterns using Fisher's exact test or Student's t test and performed multiple logistic regression analysis. The "education group" (65 physicians, 70.7 %) was more likely than the "less education group" to assess BTcP meticulously (odds ratio [OR] 17.13, 95 % confidence interval [CI] 4.98-58.94), prepare rescue medications in advance (OR 3.67, 95 % CI 1.36-9.90), and give explicit instructions regarding medications (OR 36.68, 95 % CI 5.63-239.15). Physicians who defined BTcP as occurring "after control of background pain" were more likely to explain how to take rescue medication (P < 0.05) than physicians who defined BTcP as occurring "regardless of background pain." Korean physicians' BTcP practice patterns may be affected by whether they consistently educate patients on the distinction between background pain and BTcP, regardless of their knowledge of the definition of BTcP.
Department of Family Medicine, Center for Cancer Supportive Care, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jinyoung
J
Shin
Department of Internal Medicine, Dongguk University Ilsan Hospital, Graduate School, Dongguk University-Seoul, Goyang, South Korea.
Do Yeun
DY
Kim
Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea.
Juneyoung
J
Lee
Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
Youn Seon
YS
Choi
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
In Gyu
IG
Hwang
Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, South Korea.
Sun Kyung
SK
Baek
Department of Family Medicine, Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, South Korea.
Min Seok
MS
Seo
Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea. hope@yuhs.ac.
Jae Yong
JY
Shim
D000328:Adult; D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology; D059390:Breakthrough Pain / Q000175:diagnosis* / Q000209:etiology; D000072716:Cancer Pain / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011795:Surveys and Questionnaires
Breakthrough pain; Health knowledge; Physician practice patterns