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

Yang, Yun; Yu, Xiang; Huang, Yan; Zhao, Yuan; Xu, Fei; Ying, Tian; Zou, Ben Yan; Gao, Rui; Zhang, Li

doi:10.5732/cjc.014.10031

Cited by 15 publications

(26 citation statements)

References 23 publications

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“…After pharmacist intervention, the data dropped to 11.79% at the fourth visit, and the mean pain intensity was reduced by 0.70 on a 0-10 scale. These data are consistent with the results of Edwards et al and Yang et al 19,21 The metaanalysis of Edwards et al found that the mean pain intensity in the intervention group was reduced by 0.76 on a 0-10 scale. In the study by Yang et al, 21 the uncontrolled pain rate in the GPM group was significantly lower than that of the control group (13.8% vs. 31.5%, P ¼ 0.001), and the pain score was also reduced by 1.1 to 2.5.…”

Section: Discussionsupporting

confidence: 91%

“…These data are consistent with the results of Edwards et al and Yang et al 19,21 The metaanalysis of Edwards et al found that the mean pain intensity in the intervention group was reduced by 0.76 on a 0-10 scale. In the study by Yang et al, 21 the uncontrolled pain rate in the GPM group was significantly lower than that of the control group (13.8% vs. 31.5%, P ¼ 0.001), and the pain score was also reduced by 1.1 to 2.5. The uncontrolled pain rate was slightly higher than 30%, even without pharmacist involvement, in this study and in the non-GPM group in the study by Yang et al, 21 which was lower than the literature in China, with 41.3%-52.9% of patients not being prescribed adequate analgesics or being satisfied with pain management.…”

Section: Discussionsupporting

confidence: 91%

“…In the study by Yang et al, 21 the uncontrolled pain rate in the GPM group was significantly lower than that of the control group (13.8% vs. 31.5%, P ¼ 0.001), and the pain score was also reduced by 1.1 to 2.5. The uncontrolled pain rate was slightly higher than 30%, even without pharmacist involvement, in this study and in the non-GPM group in the study by Yang et al, 21 which was lower than the literature in China, with 41.3%-52.9% of patients not being prescribed adequate analgesics or being satisfied with pain management. 10,11 This result may partially be because the 2 papers were published more than 10 years ago.…”

Section: Discussionmentioning

confidence: 78%

“…This problem was also mentioned in a previous 20 In this study, the mean pain management index (PMI; used to evaluate the adequacy of pain treatment) score for the control group was significantly lower than that of the GPM group (e0.261 vs. 0.083, P < 0.001), and 30.4% of the patients in the control group received inadequate pain treatment. 21 Although major advances occurred in the treatment of pain and our understanding of the influence of pain on clinical outcomes, numerous studies showed that the undertreatment of pain remains a problem throughout the world. A systematic review revealed that approximately onethird of patients living with cancer still have pain that is inadequately treated despite a 25% decrease in undertreatment of cancer pain between 2007 and 2013.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of pharmacist interventions as part of a multidisciplinary cancer pain management team in a Chinese academic medical center

Liu¹,

Chen²,

Luo³

et al. 2020

Journal of the American Pharmacists Association

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of pharmacist interventions as part of a multidisciplinary cancer pain management team in a Chinese academic medical center

Liu¹,

Chen²,

Luo³

et al. 2020

Journal of the American Pharmacists Association

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“…The GPM programme emphasised the control of cancer pain and reasonable application of opioids. Yang et al 24 revealed that the GPM programme could improve the pain management of patients with cancer and provide experience for improving cancer pain management in the future.…”

Section: Discussionmentioning

confidence: 99%

Consumption trend and prescription pattern of opioid analgesics in China from 2006 to 2015

Fang

Liu

et al. 2018

Eur J Hosp Pharm

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ObjectivesTo investigate the consumption trend and prescription pattern of opioids in China from 2006 to 2015, and compare the results with those of selected countries and regions, and identify the pain relief level of China.MethodsNine different opioid drugs were included in our survey, based on the whole population of China. Consumption of each type of opioid was calculated in grams in reports of the Chinese Food and Drug Administration and the International Narcotics Control Board. Then it was converted to the terms of defined daily doses and morphine equivalents. The correlation between consumption of opioids and gross domestic product, human development index and cancer incidence was analysed by Pearson’s correlation test.ResultsDefined daily doses increased by 7.89% per year since 2006, and reached 91.05 in 2015. Morphine equivalents increased by 10.57% per year since 2006, and reached 7.24 g in 2015. The average defined daily doses and morphine equivalents were 85.44 and 5.70 g respectively in 2006–2015. Annual defined daily doses of China were lower than the global average. Consumption was related to gross domestic product, but not human development index and cancer incidence. Furthermore, defined daily doses varied greatly in countries with similar gross domestic product or the human development index. Strong opioids or non-intravenous opioids always constituted the majority of opioids, and sustained an increasing tendency in consumption. The predominantly prescribed opioids were fentanyl and morphine. Consumption of oxycodone had a tendency to increase, whereas pethidine tended to decrease.ConclusionConsumption of opioids has shown an increasing tendency and in the meantime the prescription pattern has changed, indicating the progress of pain relief in China, though it remained far lower than the average global level.

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

Chuang

Chen

et al. 2020

Support Care Cancer

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Background The undertreatment of cancer pain is a global issue although many international guidelines and various studies bloom to explore the approaches in pain management. However, there is no standard care for cancer pain in routine practices. To set up a standardized procedure for improving cancer pain management in Taiwan, the Good Pain Management (GPM) program is explored to provide treatments following the US National Cancer Care Network (NCCN) Adult Cancer Pain Guideline. Method Patients diagnosed with moderate-to-severe cancer pain were eligible and randomized into the GPM or control arm and observed the first 48 h to evaluate the effects of pain management between 2 arms. Pain control, adequacy of treatments, patient satisfaction, and quality of life (QoL) of eligible patients were analyzed. Ad hoc analyses based on the pain medication category were also conducted. Result Fifty-one patients were enrolled, with 26 and 25 assigned to the GPM and control arms, respectively. Significant differences among the GPM and control arms were found including a greater decrease in the mean numerical rating scale (NRS) score in the GPM arm (− 4.6 vs. − 2.8), a lower proportion of moderate-to-severe pain in the GPM arm (23.2% vs. 39.8%), and a higher pain management index (PMI) score in the GPM arm (0.64 points vs. 0.33 points) (all p < 0.05). Ad hoc analyses revealed that the patient subgroups using strong opioids showed better patient satisfaction in GPM arm when compared with the same subgroup in the control arm. Conclusion In summary, our study demonstrated that the implementation of a standardized pain assessment and management approach (GPM ward program) showed significant improvements on pain relief, decreased the portion of moderate-to-severe cancer pain, and increased patient satisfaction in the 1st 48 h after admission. The implementation of the GPM approach in the cancer ward may provide sooner and better improvement of cancer pain management for patients who suffered moderate-tosevere cancer pain. Trial registration ClinicalTrials.gov (Identifier: NCT03155516) Keywords Good pain management. Pain control. Adequacy of pain treatment. Cancer pain Wei-Chih Su and Chieh-Han Chuang contributed equally to this work.

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

Cited by 15 publications

References 23 publications

Evaluation of pharmacist interventions as part of a multidisciplinary cancer pain management team in a Chinese academic medical center

Evaluation of pharmacist interventions as part of a multidisciplinary cancer pain management team in a Chinese academic medical center

Consumption trend and prescription pattern of opioid analgesics in China from 2006 to 2015

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

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