Management of pain in cancer patients— Lessons from practices during the COVID-19: A qualitative study of cancer care providers’ perspectives

Abstract

Background The ongoing COVID-19 pandemic has impacted health systems globally and affected managing many chronic conditions, including cancer. This study aimed to explore the perceptions of multi-disciplinary cancer care providers on how cancer pain management was affected by the COVID-19 pandemic. Methods People were eligible if they were cancer care providers of any specialty and discipline from two tertiary hospitals in Australia. Data were collected using semi-structured interviews exploring their perceptions of how COVID-19 has affected cancer pain management. Thematic analysis of interview transcripts used an integrated approach that started with inductive coding before coding deductively against a framework for behaviour change called the COM-B Model which proposes that ‘capability’, ‘motivation’ and ‘opportunity’ are requisites for any behaviour. Results Twenty-three providers participated. Five themes were developed and interpreted from the analysis of data, namely: “Telehealth enables remote access to cancer pain management but also created a digital divide”, “Access to cancer pain management in the community is compromised due to the pandemic”, “COVID-19 negatively impacts hospital resource allocation”, “Patients were required to trade off cancer pain management against other health priorities” and “Hospital restrictions result in decreased social and psychological support for patients with cancer pain”. Conclusions The landscape of the cancer pain management health system in Australia underwent substantial shifts during the COVID-19 pandemic, with lasting impacts. This study identifies unique challenges faced by patients with cancer that were not well studied amongst ample literature on pandemic pain management.