Assessing the Quality of Pain Care in Ambulatory Patients With Advanced Stage Cancer

Weingart, Saul N.; Cleary, Angela; Stuver, Sherri O.; Lynch, Maureen; Brandoff, Douglas; Schaefer, Kristen G.; Zhu, Jun; Berry, Donna L.; Block, Susan D.; Weeks, Jane C.

doi:10.1016/j.jpainsymman.2011.06.022

Cited by 11 publications

(10 citation statements)

References 45 publications

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“…Yet, they did not objectively study medical records, but they asked patients whether the doctor assessed pain. The figures in our study are in accordance with a study of Weingart et al., who found that pain assessment in ambulatory patients with cancer was insufficient. Obviously, the clinical practice guideline has not been implemented in the working method of medical oncologists in the participating hospitals.…”

Section: Discussionsupporting

confidence: 93%

The Impact of a National Guideline on the Management of Cancer Pain on the Practice of Pain Assessment and Registration

et al. 2014

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The Dutch clinical practice guideline on the diagnosis and management of pain in patients with cancer was published in 2008 and intensively promoted to healthcare professionals who see patients with cancer. One of the most important recommendations is the systematic registering of the pain and its intensity. To evaluate in which degree this part of the practice guideline is implemented, we analyzed the medical records of patients attending the outpatient oncological clinic in an academic hospital, a large teaching hospital, and 4 smaller peripheral hospitals. None of the participating hospitals assessed pain by a standardized scale. Reference to pain in the medical record happened more frequently in the academic hospital than in the other hospitals. The frequency of recording pain in the medical record in the academic hospital was much higher in this study than the one previously reported, whereas the findings in the other hospitals were comparable. There may be several reasons for the difference in reporting rate of pain in patients with cancer. Our findings indicate that the clinical practice guideline with regard to pain registration is poorly implemented in oncology outpatient clinics. More efforts should be made to generate the awareness for the need of pain registration.

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Section: Discussionsupporting

confidence: 93%

The Impact of a National Guideline on the Management of Cancer Pain on the Practice of Pain Assessment and Registration

et al. 2014

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“…In addition to analgesics, effective management of cancer pain also depends on clinicians having a flexible approach and detailed knowledge regarding the range of available analgesic options and preparations. Undertreatment is usually attributed to inappropriate opioid use, which results from factors that can pertain to patients, family, institutions, society and even healthcare providers ( 5 ). Since unresolved pain detrimentally affects physical functioning, psychological well-being and social interaction ( 6 ); education and occupational guidelines are integral to the achievement of better pain control.…”

Section: Introductionmentioning

confidence: 99%

The impact of pain control on physical and psychiatric functions of cancer patients: a nation-wide survey in Taiwan

Rau

Chen

et al. 2015

Jpn. J. Clin. Oncol.

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ObjectiveTo investigate the prevalence of pain in cancer patients at different disease statuses, the impact of pain on physical and psychiatric functions of patients and the satisfaction of pain control of patients at outpatient clinic department in Taiwan.MethodsShort form of the Brief Pain Inventory was used as the outcome questionnaire. Unselected patients of different cancers and different disease statuses at outpatient clinic department were included. The impacts of their current pain control on physical function, psychiatric function and the satisfaction of doctors were evaluated. Logistic regression analyses were performed to evaluate whether the interference scale performed identically in the different analgesic ladders. The dependent variables were satisfaction toward physician and treatment.ResultsA total of 14 sites enrolled 2075 patients in the study. One thousand and fifty-one patients reported pain within the last 1 week. In patients whose diseases deteriorated, >60% of them need analgesics for pain control. Pain influenced physical and psychiatric functions of patients, especially in the deteriorated status. More than 80% of patients were satisfied about current pain control, satisfaction rate related to disease status, pain intensities and treatments for pain.ConclusionOur study found that different cancers at different statuses had pain at variable severity. Pain can influence physical and psychological functions significantly. More than 75% of subjects reported satisfaction over physician and pain management in outpatient clinic department patients with cancer pain in Taiwan.

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“…The Institute of Medicine reported that 50% of cancer patients around the world had pain. 22 In USA, Weingart 23 examined the quality of cancer pain care and reported that among advanced cancer patients with severe pain, 34% of patients continued to report severe pain a month after the visit. In Italy, 40.3% of cancer patient with pain had breakthrough pain, but most of them being untreated did not.…”

Section: Undertreatment Of Cancer Painmentioning

confidence: 99%

Undertreatment of caner pain

Lee

Wang

2015

Acta Anaesthesiologica Taiwanica

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Pain is a burdensome symptom that can commonly exist chronically along the cancer trajectory. Uncontrolled pain will impact on cancer patients' quality of life, even further negatively affect cancer survivors' employment. Based on systemic reviews of studies for past 10 years, the paper reported that although there is enormous advancement on the knowledge of cancer pain and pain management, studies still documented undertreatment of cancer pain globally. Additionally, pain distress a significant portion of cancer survivors. The pain in cancer survivors distinct from the pain related with cancer, instead emphasize on pain related with cancer treatment, such as neuropathic pain, muscular syndrome. Evidence-based pain management with common pain problems in cancer survivors is lacking. Further studies are needed to understand the pain in cancer survivors and to develop effective strategies in helping cancer survivors to manage their pain.

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Assessing the Quality of Pain Care in Ambulatory Patients With Advanced Stage Cancer

Abstract: There is room for improvement in the pain care of patients with advanced cancer. Additional research is needed to understand the reasons for poor performance.

Cited by 11 publications

References 45 publications

The Impact of a National Guideline on the Management of Cancer Pain on the Practice of Pain Assessment and Registration

The Impact of a National Guideline on the Management of Cancer Pain on the Practice of Pain Assessment and Registration

The impact of pain control on physical and psychiatric functions of cancer patients: a nation-wide survey in Taiwan

Undertreatment of caner pain

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