Patient and Physician Satisfaction with Analgesic Treatment: Findings from the Analgesic Treatment for Cancer Pain in Southeast Asia (ACE) Study

Abstract

Aim The aim of this study was to examine patients' and physicians' satisfaction, and concordance of patient-physician satisfaction with patients' pain control status. Methods This cross-sectional observational study involved 465 adults prescribed analgesics for cancer-related pain from 22 sites across Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam. Pain intensity, pain control satisfaction, and adequacy of analgesics for pain control were documented using questionnaires. Results Most patients (84.4%) had stage III or IV cancer. On a scale of 0 (no pain) to 10 (worse pain), patients' mean worst pain intensity over 24 hours was 4.76 (SD 2.47). More physicians (19.0%) than patients (8.0%) reported dissatisfaction with patient's pain control. Concordance of patient-physician satisfaction was low (weighted kappa 0.36; 95% CI 0.03–0.24). Most physicians (71.2%) found analgesics to be adequate for pain control. Patients' and physicians' satisfaction with pain control and physician-assessed analgesic adequacy were significantly different across countries (P < 0.001 for all). Conclusions Despite pain-related problems with sleep and quality of life, patients were generally satisfied with their pain control status. Interestingly, physicians were more likely to be dissatisfied with patients' pain control. Enhanced patient-physician communication, physicians' proactivity in managing opioid-induced adverse effects, and accessibility of analgesics have been identified to be crucial for successful cancer pain management. This study was registered at ClinicalTrials.gov (identifier NCT02664987).

Managing Pain in People with Cancer—a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public

“…These findings are consistent with those of recent studies and systematic reviews [12,13,20,26,37,79,80,96]. Thus, it can be argued that due to these negative attitudes and lack of knowledge towards CPM, the management of cancer pain remains a major problem worldwide, especially in countries within Europe, Africa and Asia [13,26,52,75,76,81,92]. These could be due to lack of education and training about CPM among professionals and lack of general awareness and adequate level of knowledge about CPM among patients, caregivers and the public, as these were stated in all of the included studies.…”

“…Morphine remains the most effective and recommended treatment for CPM [99,103]. Despite the improving quality of pharmacological options for pain management, several studies have revealed that patients at different stages of their disease still do not receive appropriate CPM [3,18,25,37,52,92]. Lack of knowledge and negative attitudes towards Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13187-019-01548-9) contains supplementary material, which is available to authorized users.…”

Barriers to cancer pain management from the perspective of patients: A qualitative study

“…Although cancer pain is a long-standing problem (Erol et al, 2018), its effective management in people with cancer is still a major challenge for patients and their families and needs more attention and evaluation by the healthcare providers (Dabbous et al, 2017;Erol et al, 2018). Thinh et al found that despite the availability of cancer pain management guidelines and effective analgesics, a significant number of people with cancer reported inadequate pain treatment which consequently affects their quality of life and sleep (Thinh et al, 2018). It is clear that healthcare providers need to be aware of barriers to pain management to plan effective educational programs and supportive services for improving the quality of life of patients and their families (Ovayolu et al, 2015).…”

Integrating Cancer Patients’ Satisfaction with Rescue Medication in Pain Assessments

“…Pain management assessment can also be complex because the relationship between pain severity and its interference with function is non-linear 20 . Furthermore, there is frequently disagreement between a patient s self-reported pain and the physician s clinical assessment of that pain 21,22 . Adequate, effective pain assessment is significantly affected by regional and institutional differences in medical provider perceptions and the extent to which opioid analgesics are used, among other factors 23,24 .…”