Inadequate Management of Chronic Non-cancer Pain and Treatment-Related Adverse Events in Asia: Perspectives from Patients from 10 Countries/Regions

Abstract

Findings from the published ACHEON study revealed inadequate pain relief for chronic non-cancer pain (CNCP) across 10 Asian countries/regions. Hence, we performed additional analyses on the survey data to understand management practices for relieving CNCP and treatment-related adverse events (AEs). Descriptive statistics were used to summarize patients' profile, prescribed treatments, and associated AEs. Two-sample t test was used to compare pain levels between treatment groups. Univariate analyses were conducted to identify factors associated with pain intensity, presence of any common AEs, perceived treatment adequacy, patient-physician interaction, and employment status. Of 1305 patients surveyed, the median duration of CNCP was 24 (interquartile range, 39) months. The majority of patients (89.3%) reported having moderate (44.4%) or severe pain (44.9%). Most patients (80.1%) were prescribed non-opioids, while 16.2% of patients were untreated for pain. Although over half of the treated patients (53.8%) experienced AEs while receiving pain treatment, two-fifths were prescribed medications to manage these AEs. High pain levels, presence of AEs, and employment status influenced patients' perception of treatment adequacy. Patients were more willing to inform their physicians when pain levels were higher and when they perceived sufficient time with physicians. These findings revealed inadequate treatment of CNCP in patients from the participating countries/regions. CNCP management may be improved through increased physician-patient interaction time and adopting a biopsychosocial model for treatment. A proactive and multidimensional approach is required to manage CNCP and potential treatment-related AEs so as to provide optimal care for patients experiencing CNCP.

Pain relief and associated factors: a cross-sectional observational web-based study in a Quebec cohort of persons living with chronic pain

“…Unfortunately, their expectations regarding medication efficacy are often unrealistically high (e.g., expecting complete pain relief), and these expectations are seldom discussed with healthcare professionals to jointly establish realistic and achievable therapeutic goals (23). Moreover, a substantial proportion perceive their treatment as inadequate (37%-64%) (24,25). The heterogeneity of people living with CP who present with different comorbidities and symptoms of pain may complexify the multimodal approaches proposed by healthcare professionals (26).…”

“…Understanding the efficacy of the multimodal approach in realworld clinical settings and unveiling modifiable factors associated with greater pain relief could help provide manageable solutions to alleviate CP and to improve its management, especially for persons without access to facilities offering multidisciplinary care. However, the evidence regarding the efficacy of pain treatments comes mainly from the results of experimental or quasiexperimental clinical trials (14,15,24,25,27). To our knowledge, a few observational studies representing the realworld have examined self-reported pain relief experienced by people living with CP in the community with their diverse array of treatments (24,25).…”

Concept of the Number Needed to Treat for the Analysis of Pain Relief Outcomes in Patients Treated with Spinal Cord Stimulation

“…Chronic pain is a common problem among adults, with prevalence studies suggesting that one in five are affected [ 1 , 2 ]. Despite considerable advances in our understanding, diagnosis, and management of pain, many patients report inadequate pain control [ 2 , 3 , 4 , 5 ]. Effective pain management strategies are needed to address unrelieved pain among this population.…”

Perspectives of pain specialists, patients, and family members on long-term opioid use for chronic non-cancer pain: a qualitative study

“…The aims of treatment in these patients focus on reducing pain scores and improving function and quality of life. However, many patients continue to suffer from pain after receiving long-term non-opioid and non-pharmacological therapy [ 5 ]. Opioids are potent pain medications for moderate to severe pain management.…”