Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India

Aim:Chronic pain is common in terminally ill patients with cancer and affects their quality of life. In this study, we wanted to evaluate pain severity and the adequacy of prescribed analgesics in terminally ill patients with cancer in North Palestine.Methods:We conducted a cross-sectional descriptive study in North Palestine on 77 terminally ill patients with cancer. Pain experience was evaluated with Brief Pain Inventory-Short Form (BPI-SF). Pain management index (PMI) was calculated to determine the adequacy of interventions. The relationships between adequacy of pain management and socioeconomic and clinical factors were analyzed by the covariance method. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS version 15.0 [SPSS Inc., Chicago, USA]).Results:Fifty-nine patients (76.6%) reported moderate-to-severe pain. According to the PMI, only 64.9% of the patients received adequate pain management. Thirty-five patients (45%) wanted additional treatment or an increase in the dose of pain medications. Although men and women reported similar pain severities, women were more likely to be inadequately treated (P = 0.027). Pain severity was significantly less in patients who received health-care services at least once in the last month before the interview, compared to those without recent access to health care (P = 0.024).Conclusion:There is substantial inadequacy in pain management in patients with cancer. The BPI-SF should be routinely used to evaluate pain severity, and analgesics should be prescribed equitably without discrimination with regard to gender and socioeconomic status of patients.

“…[829] Lower education level was not a significant predictor in our study, but other studies have found lower education to be a significant factor, more so in developing nations. [3031]…”

Section: Discussionmentioning

confidence: 99%

Pain severity and adequacy of pain management in terminally ill patients with cancer: An experience from North Palestine

Mallah

Mousa

Fadl

et al. 2019

“…[39] Even among the patients who reach tertiary level cancer centers, 96% currently do not have proper palliative care access. [40] The existing palliative care system is not enough for cancer patients alone, centers catering to other noncommunicable conditions are fewer. [3638] With the epidemiological transition, the prevalence of noncommunicable diseases (NCDs) are rising, and they will also create a strain on the palliative care system.…”

Section: Palliative Care Provision In Indiamentioning

confidence: 99%

Current asbestos exposure and future need for palliative care in India

Jadhav

Gawde

2019

Asbestos-related diseases (ARDs) are incurable but entirely preventable. Due to India's continuing use of asbestos, ARD patients will increase to a high number in the next three to four decades. This will increase the burden on palliative care system which is in nascent stage presently. Palliative care is the mainstay of the management of ARDs. Unfortunately, the burden on palliative care is likely to increase due to multiple factors contributed by India's demographic and economic changes. In the near future, there will be at least 12.5 million ARD patients and 1.25 million asbestos-related cancer patients worldwide, and half of these will be in India. It is high time to introspect about our ability to engage with this future problem. The paper also discusses the organization of this future problem of ARDs and possible action points toward future access to palliative care for ARD patients.

“…[ 4 ] In a study done in four regional cancer centers in India, a total of 88% of patients reported experiencing pain for about 7 days, and approximately 60% reported that their worst pain was severe. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Indian society for study of pain, cancer pain special interest group guidelines on pharmacological management of cancer pain (Part I)

Thota¹,

Ramanjulu²,

Ahmed³

et al. 2020

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group guidelines on pharmacological management of cancer pain in adults provides a structured, step-wise approach which will help to improve the management of cancer pain and to provide the patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs, patient population, and situations in India. A questionnaire based on the key elements of each sub drafts addressing certain inconclusive areas where evidence was lacking, was made available on the ISSP website, and circulated by E-mail to all the ISSP and Indian Association of Palliative Care (IAPC) members. We recommend that analgesics for cancer pain management should follow the World Health Organization three-step analgesic ladder appropriate for the severity of pain. The use of paracetamol and nonsteroidal anti-inflammatory drugs alone or in combination with opioids for mild-to-moderate pain should be used. For mild-to-moderate pain, weak opioids such as tramadol, tapentadol, and codeine can be given in combination with nonopioid analgesics. We recommend morphine as the opioid of first choice for moderate-to-severe cancer pain.