Managing Pain in Patients With Cancer: The Chinese Good Pain Management Experience

Abstract

PurposeThe number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer.MethodsWe describe procedures for the selection, implementation, and assessment procedures for model cancer wards. We analyzed published results in areas of staff training and patient education, pain management in practice, analgesic drugs administration, and patient follow-up and satisfaction.ResultsPain management training enabled medical staff to accurately assess the level of pain and to provide effective pain relief through timely dispensation of medication. Patients with good knowledge of treatment of pain were able to overcome their aversion to opioid drugs and cooperate with nursing staff on pain assessment to achieve effective drug dose titration. Consumption of strong opioid drugs increased significantly; however, there was no change for weaker opioids. Higher pain remission rates were achieved for patients with moderate-to-severe pain levels. Proper patient follow-up after discharge enabled improved outcomes to be maintained.ConclusionThe GPM program has instituted a consistent and high standard of care for pain management at cancer wards and improved the quality of life for patients with cancer.

Effects of Good Pain Management (GPM) ward program on patterns of care and pain control in patients with cancer pain in Taiwan

“…This GPM program has been implemented in China and our results are similar to studies conducted in China in supporting the standardized GPM program to improve pain control [17,18]. Yang et al [17] revealed that the mean PMI score for the GPM ward was significantly higher than for the control arm.…”

“…In America, various randomized studies were conducted for the assessment of effects on the education for pain in cancer patients and results showed a decrease in pain intensity following the education [14][15][16]. Additionally, the Good Pain Management (GPM) ward program implemented in China improved the quality of life (QoL) for patients [17,18].…”

The use of distress thermometer in advanced cancer inpatients with pain

“…From this point of view, most cancer pain in the present study was not effectively controlled. The main barriers to better pain management in China were reported as inadequate medical knowledge, pain assessment and its management, a very complicated procedure for opioid prescription, and generally low levels of patient compliance for analgesics for fear of addiction, drug tolerance, and adverse effects . The under‐treatment of cancer pain and its influence on psychological distress in this study emphasizes the importance of assessing and managing pain among advanced cancer patients.…”

Stress and Perception of Procedural Pain Management in Chinese Parents of Children With Cancer

“…The perception and expression of pain is shaped by the cultural expectation. 5,11,12 Concepts and faiths within the Chinese culture can shape the sociocultural dimension of the cancer pain experience. For example, pain is perceived to be an essential part of life under the influence of Confucian, which might result in the unnecessary suffering of pain.…”