Special aspects of cancer pain management in a Chinese general hospital

Yu, Shiying; Wang, Xin Shelley; Cheng, Yongjun; Yang, Jiaying; Cleeland, Charles S.

doi:10.1053/eujp.2001.0274

Cited by 36 publications

(31 citation statements)

References 7 publications

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“…As expected, professional-related barriers included insufficient knowledge and poor evaluation of pain, lack of adherence to pain management guidelines, too much concern about addiction, and a low priority given to cancer pain control in treatment. Above all, several studies have reported that medical staff frequently have erroneous knowledge and simply do not pay attention to pain assessment [7,8,9,10]. Other factors such as reluctance to prescribe opioids, lack of access to opioids, and excessive regulation to prevent over-prescribing of opioids were demonstrated less frequently.…”

Section: Introductionmentioning

confidence: 99%

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians

et al. 2014

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PurposeAlthough cancer pain is prevalent, under-treatment still remains a problem. Knowledge of and compliance with guidelines for management of cancer pain were analyzed for exploration of physician-related barriers to cancer pain management. In addition, physicians' knowledge and its correlation with cancer pain control were audited.Materials and MethodsFrom July 8 to December 2, 2010, a nationwide survey of house staff enquired about their knowledge of cancer pain control guidelines, and the medical records of patients under their care were analyzed.ResultsIn total, 180 physicians participated in the study. Their average score for knowledge was 14.6 (range, 7 to 19; maximum possible, 20). When the knowledge score was divided into low, medium, and high scores, patients receiving care from physicians with high levels of knowledge tended to have better cancer pain control (p<0.001). Of the total patients with severe pain, 19.5% were not prescribed strong opioids, and 40% were not prescribed any medication for breakthrough pain.ConclusionPhysicians' knowledge of guidelines for control of cancer pain showed an association with improvement of pain management. Overall adherence to the guidelines was lacking. Continuous interventions such as education and audits regarding cancer pain control guidelines for physician are needed.

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Section: Introductionmentioning

confidence: 99%

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians

et al. 2014

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“…Second, due to a lack of personalized pain control knowledge, some medical staff could not appropriately manage pain. Third, some local hospital policies for regulating narcotics might restrict the use of opioid analgesics[10], [14]–[18].…”

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confidence: 99%

The Good Pain Management (GPM) Ward Program in China and its impact on Chinese cancer patients: the SYSUCC experience

Yang

Yu²,

Huang³

et al. 2014

Chin J Cancer

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To improve cancer pain management, the Medical Oncology Department of Sun Yat-sen University Cancer Center (SYSUCC) launched the Good Pain Management (GPM) Ward Program, which has been recognized by the Chinese Ministry of Health and promoted throughout the nation. This retrospective case-control study was designed to evaluate the effectiveness of the program. Patients diagnosed with malignant solid tumors with bone metastasis were eligible. Patients who were admitted 6 months before the initiation of the GPM program were used as the control group, and patients admitted 6 months after the initiation of the program were used as the GPM group. The pain-reporting rate and pain management index (PMI) were calculated. The pain levels before and after pain management were compared. A total of 475 patients (244 in the control group and 231 in the GPM group) were analyzed. The pain-reporting rate of the GPM group was significantly higher than that of the control group (62.8% vs. 37.7%, P < 0.001). The PMI of the GPM group was significantly higher than that of the control group (0.083 vs. -0.261, P < 0.001). Therefore, the GPM Ward Program improved the pain management of cancer patients and provided experience for improving cancer pain management in the future.

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“…Because of pharmacological characteristic of transdermal fentanyl, it was mild for nausea, vomiting, constipation, and the risk of abuse was obviously decreased. There was no report about abusing and addiction (psychological dependence) for transdermal fentanyl [7] . The patch is used to cancer patients with chronic pain, especially to patients with difficulty swallowing, gastrointestinal dysfunction and outpatients with advance cancer.…”

Section: Discussionmentioning

confidence: 99%

Transdermal Fentanyl for Management of Cancer Pain in Elderly Patients in China

Sun

Zhang

et al. 2004

Chinese-German J Clin Oncol

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Objective: To assess the effect and adverse effects of transdermal fentanyl for elderly patients with cancer pain in China. Methods: A total of 1664 elderly patients (aged 65-90 with mean age of 72.6) with cancer pain enrolled in the multicenter study from 136 institutes in China. Of them, 408 (28.8%) patients were 75 years old or older. All patients received transdermal fentanyl for the management of cancer pain. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results: Baseline mean of pain intensity was 7.34. On day 1, 3, 6, 9 15, and 30, the pain mean scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, 1.64 (P = 0.000). The effective rate was 97.18%. The mean doses of fentanyl was 31.34 µg/h (25-150 µg/h) initially, and 40.59 µg/h and 47.50 µg/h (25-200 µg/h) at day 15 and day 30. At treatment day 15, the dose of fentanyl was ranged from 25 to 50 µg/h in 91.8% of patients, 75 to 100 µg/h in 7.5% patients, and 125 to 200 µg/h only in 0.8% patients. The fine quality of life was in 25.4% patients before treatment, and was 71.15% and 73.04% at day 15 and day 30 respectively (P =0.0000). The common side effects were constipation (10.70%), nausea (11.96%), dizzy (6.85%), vomiting (3.85%), sedation (2.40%), respiratory depression (0.12%). 86.2% patients preferred continue treated by transdermal fentanyl. Conclusion: Transdermal fentanyl for the elderly with cancer pain is effective, safe, convenient, and can improve the quality of life. Transdermal fentanyl can be recommended as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain, and the initial doses is recommended as 25 µg/h. The elderly patients are mostly population in the cancer. About half of the patients with cancer are over age 65. Whereas, there are a few of date about clinical trial for elderly patients before the new medicine in due form approved for clinic use. Statistically, the age is younger 10 years old in clinical trial population than in real cancer patient's population. In the most of clinical study, the exclude criteria of age are over 70 or 75 years old. Therefore, there were less than one fourth of the patients aged over 65 years old enrolled the clinical trial for new medicine. The age of elder might interfere to estimate the validity and safety of new medicine and new method, because of the impaired function of important organ and the more pre-existing or concomitant painful conditions common in elderly group. It is necessary to study the cancer pain management for elderly patients with cancer pain by new medicine or new method. The transdermal fentanyl patch is the transdermal drug of the strong opioid analgesics [1] . There is a lack of multicenter clinical trials on transdermal fentanyl patch therapy for elderly patients with cancer pain. The purpose of multicenter clinical trial is to Correspondence to: YU Shiying evaluate the effect and side effects of transdermal fentanyl for elderly patients with cancer pain in China. Patients and ...

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Special aspects of cancer pain management in a Chinese general hospital

Cited by 36 publications

References 7 publications

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians

The Good Pain Management (GPM) Ward Program in China and its impact on Chinese cancer patients: the SYSUCC experience

Transdermal Fentanyl for Management of Cancer Pain in Elderly Patients in China

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