The Influence of Pain Severity and Interference on Satisfaction with Pain Management among Middle-Aged and Older Adults

Baker, Tamara A.; Krok‐Schoen, Jessica L.; O’Connor, Melissa; Brooks, Amber

doi:10.1155/2016/9561024

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…Patient satisfaction may be used as a key indicator of the effectiveness of cancer pain management in terms of analgesic treatment outcomes [ 4 ]. Previous studies have shown that higher patient satisfaction directly influences treatment adherence [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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

Thinh

Sriraj

Mansor

et al. 2018

Pain Research and Management

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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).

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Section: Introductionmentioning

confidence: 99%

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

Thinh

Sriraj

Mansor

et al. 2018

Pain Research and Management

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show abstract

“… 26 Younger patients and those with greater financial difficulties were more likely to experience pain during their last year of life. Younger patients may have less effective coping mechanisms 27 and may be less satisfied with pain treatment 28 than their older counterparts, and therefore report higher pain.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pain Among Patients with Solid Metastatic Cancer During the Last Year of Life

Chaudhry¹,

Shafiq²,

Teo³

et al. 2022

JPR

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Background Despite medical advancements, pain is a major source of suffering at the end of life for patients with a solid metastatic cancer. We aimed to assess the trajectory of pain prevalence, severity, interference, and inadequacy of analgesia during the last year of life. Methods We analysed data from the last year of life of 345 decedents from a prospective cohort study of 600 patients with a solid metastatic cancer in Singapore. Patients were surveyed every 3 months and their pain outcomes (prevalence, severity, and interference) and inadequacy of analgesia were analysed. We used mixed-effects regressions to assess the association of pain outcomes with patients’ time from death, demographics, and planned or unplanned hospitalisations. Results Prevalence of pain was higher in the last 2 months (65%) compared to 11 to 12 months (41%) before death. Pain severity and interference scores (mean ± SD) were also higher in the last month (severity: 2.5±2.6; interference: 2.6±3.0) compared to 12 months before death (severity: 1.4±2.0; interference: 1.4±2.0). At any time during the last year of life, 38% of the patients were prescribed non-steroidal anti-inflammatory drugs, 11% were prescribed weak-opioids and 29% were prescribed strong opioids. These analgesics were prescribed through either oral, topical or injectable route. Pain outcomes were significantly worse (p-value<0.05) for younger patients, those with higher education, and more financial difficulties, while interference was higher after an unplanned hospitalisation in the last month. Females reported higher pain severity score during their last year of life compared to males. For patients reporting moderate to severe pain, inadequacy of analgesia was lower in the last 2 months (43%) compared to 11 to 12 months before death (83%). Conclusion Findings highlight the need for greater attention in monitoring and treatment of pain even earlier in the disease trajectory, and increased attention to patients discharged from an unplanned hospitalisation.

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“…Interestingly, older patients have been found to be more satisfied with their pain treatment compared to middle-aged adults despite increasing levels of pain, which could be related to their perception that pain is to be expected as one grows older. [ 2 ] A systematic review of 17 studies found that older adults also equated pain with disease progression, helplessness, and uncertainty about the future. Investigators also found that fear exists that analgesics contribute to untoward side effects.…”

Section: The Experience Of Cancer Pain In Older Adultsmentioning

confidence: 99%

Assessment and Management of Cancer Pain in Older Adults: Strategies for Success

Brant

2018

Asia-Pacific Journal of Oncology Nursing

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Pain is a significant problem in older adults with cancer as older adults often receive suboptimal pain management. While overmedication can lead to adverse effects, under management of pain can lead to physiological and psychological problems such as functional decline and depression. This manuscript will discuss the assessment and management of pain in older adults, in consideration of the pharmacodynamic changes related to aging and other individual considerations. Current evidence from filtered and unfiltered sources, PubMed, current guidelines. Unrelieved pain can have a detrimental impact on older adults. A team approach is essential to assess patients at each encounter, consider the social environment in which the patient resides, and employ pharmacologic and nonpharmacologic strategies that are evidence-based and are tailored to the specific cancer pain syndrome.

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The Influence of Pain Severity and Interference on Satisfaction with Pain Management among Middle-Aged and Older Adults

Cited by 7 publications

References 28 publications

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

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

Epidemiology of Pain Among Patients with Solid Metastatic Cancer During the Last Year of Life

Assessment and Management of Cancer Pain in Older Adults: Strategies for Success

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