Adequacy of Pain Control in Patients With Advanced Cancer in Pakistan

Majeed, Muhammad Hassan; Nadeem, Ramsha; Khokhar, Muhammad Abbas; Qaisar, Muhammad Nawaz

doi:10.1177/0825859718800490

Cited by 11 publications

(11 citation statements)

References 36 publications

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“…In this study, 67.5% (95% CI 62.8 to 72) of participants received adequate CRP management. This finding is in line with studies from Palestine (64.9%)17 and Pakistan (63.95%) 18. However, this finding is higher as compared with a previous study done in Gondar (35%)8 and Mekelle (56.1%) in Ethiopia,10 Mozambique (31.3%),19 the Middle East (55%),20 Japan (62.7%) (30%)21 22 and India (23%) 23.…”

Section: Discussionsupporting

confidence: 90%

Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

Mihiretie,

Siyum,

Tamene

2024

BMJ Open

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ObjectiveThe aim of this study was to assess the adequacy of cancer-related pain (CRP) management and associated factors among patients with cancer in the Northwest oncology centres of Ethiopia.Design and settingAn institutional-based multicentre cross-sectional study was conducted among patients with cancer in the Northwest oncology centres of Ethiopia from May to July 2022.ParticipantsAll oncology patients at selected hospitals who fulfilled the inclusion criteria during the data collection period were the study population.Main outcome measuresThe main outcome of this study was the adequacy of CRP management, which was measured by the Pain Management Index (PMI). A systematic random sampling technique was used to select representatives from each study area. Data entry and analysis were done using EpiData V.4.6.1 and SPSS V.26, respectively. Binary logistic regression was conducted to determine independent predictors of the adequacy of CRP management. A p value of <0.05 was considered statistically significant.ResultsFrom a total of 422 included respondents, about 67.5% of the participants had adequate CRP management (95% CI 62.8 to 72). Good performance status (adjusted OR (AOR)=0.44; 95% CI 0.24 to 0.80), presence of comorbidity (AOR=3.28; 95% CI 1.68 to 6.38) and pain history (AOR=0.33; 95% CI 0.01 to 0.11) were significantly associated with the adequacy of cancer pain management.ConclusionUsing PMI status in the Northwest oncology centre of Ethiopia, more than two-thirds of patients with CRP obtained adequate pain management. The adequacy of CRP management was found to be influenced by factors like comorbidity, past pain history and Eastern cooperative oncology group performance status.

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Section: Discussionsupporting

confidence: 90%

Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

Mihiretie,

Siyum,

Tamene

2024

BMJ Open

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“…[2324] Recent studies in developing countries report serious undertreatment of pain in cancer patients, with a frequent lack of prescriptions for opioids despite obvious indications. [2526] Therefore, inadequate pain management in cancer patients is a global issue, and its magnitude varies considerably across health-care settings in different continents.…”

Section: Discussionmentioning

confidence: 99%

Pain severity and adequacy of pain management in terminally ill patients with cancer: An experience from North Palestine

Mallah

Mousa

Fadl

et al. 2019

Indian J Palliat Care

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Aim:Chronic pain is common in terminally ill patients with cancer and affects their quality of life. In this study, we wanted to evaluate pain severity and the adequacy of prescribed analgesics in terminally ill patients with cancer in North Palestine.Methods:We conducted a cross-sectional descriptive study in North Palestine on 77 terminally ill patients with cancer. Pain experience was evaluated with Brief Pain Inventory-Short Form (BPI-SF). Pain management index (PMI) was calculated to determine the adequacy of interventions. The relationships between adequacy of pain management and socioeconomic and clinical factors were analyzed by the covariance method. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS version 15.0 [SPSS Inc., Chicago, USA]).Results:Fifty-nine patients (76.6%) reported moderate-to-severe pain. According to the PMI, only 64.9% of the patients received adequate pain management. Thirty-five patients (45%) wanted additional treatment or an increase in the dose of pain medications. Although men and women reported similar pain severities, women were more likely to be inadequately treated (P = 0.027). Pain severity was significantly less in patients who received health-care services at least once in the last month before the interview, compared to those without recent access to health care (P = 0.024).Conclusion:There is substantial inadequacy in pain management in patients with cancer. The BPI-SF should be routinely used to evaluate pain severity, and analgesics should be prescribed equitably without discrimination with regard to gender and socioeconomic status of patients.

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“…25 In a comparative study, US respondents were twice as likely as Japanese physicians to indicate that opioid treatment was a legal expectation. 21 Whilst no Asian country has laws which prohibit opioid availability, a lack of legal obligation to enable access to opioids creates a regulatory climate where clinicians may fear criminal accountability for mis-prescribing. A cross-sectional study in China, found that 62.8% of clinicians had concerns about regulatory investigation for prescribing opioids.…”

Section: Legal Regulatory and Socio-politicalmentioning

confidence: 99%

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

et al. 2020

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Background: Opioids are essential medicines. Despite international and national laws permitting availability, opioid access remains inadequate, particularly in South, Southeast, East and Central Asia. Aim: To review evidence of perceptions and experiences of regulatory enablers and barriers to opioid access in South, Southeast, East and Central Asia. Design: Systematic review of post-2000 research according to PRISMA guidelines. Data were subjected to critical interpretive synthesis. International, national and sub-national barriers were organised developing a conceptual framework of opioid availability. Data sources: PsycINFO, Medline, Embase, The Cochrane Library. CINAHL, Complete and ASSIA from 2000 until 20th May 2019. Results: 21/14097 studies included: quantitative n = 15, qualitative n = 3 and mixed-methods n = 3. Four barrier/enabler themes were developed: Legal, regulatory, socio-political; lack of laws explicitly enabling opioid access, restrictive international controls and clinician prescribing concerns. Opioid availability; limited availability, poor policymaker and clinician education regarding opioid benefits, poor continuity of supply. Opioid Accessibility; medicine costs, distance to prescribing centres. Prescribing; extensive bureaucratic barriers, lack of human resources for prescribing. We present a novel framework of a self-perpetuating model of inadequate opioid provision. The Single Convention on Narcotics provides the context of restrictive laws and negative attitudes amongst policymakers. A consequent lack of prescribers and clinicians’ negative attitudes at sub-national levels, results in inadequate access to and use of opioids. Data of inadequate consumption informs annual requirement estimates used by the International Narcotics Control Board to determine future opioid availability. Conclusions: Regulatory and socio-political actions unintentionally limit opioid access. International and national laws explicitly enabling opioid access are required, to assuage concerns, promote training and appropriate prescribing.

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Adequacy of Pain Control in Patients With Advanced Cancer in Pakistan

Cited by 11 publications

References 36 publications

Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study

Pain severity and adequacy of pain management in terminally ill patients with cancer: An experience from North Palestine

Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: A systematic review, critical interpretative synthesis and development of a conceptual framework

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