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

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dang Huy Quoc Thinh ◽  
Wimonrat Sriraj ◽  
Marzida Mansor ◽  
Kian Hian Tan ◽  
Cosphiadi Irawan ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Pain Intensity ◽  
Pain Control ◽  
Weighted Kappa ◽  
Physician Satisfaction ◽  
Cross Sectional ◽  
Analgesic Treatment ◽  
Ace Study ◽  
Pain Patients

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).

Patient and physician satisfaction with analgesic treatment in Southeast Asia (SEA): Findings from the analgesic treatment for cancer pain in Southeast Asia (ACE) study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21698-e21698
Author(s):  
Hanlim Moon ◽  
Dang Huy Quoc Thinh ◽  
Wimonrat Sriraj ◽  
Marzida Binti Mansor ◽  
Kian Hian Tan ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Cancer Pain ◽  
Sleep Disturbance ◽  
Pain Intensity ◽  
Pain Control ◽  
Oral Morphine ◽  
Physician Satisfaction ◽  
Analgesic Treatment ◽  
Ace Study ◽  
Pain Status

e21698 Background: Adequate dosing of analgesics is important for optimum cancer pain control & quality of life (QoL). To understand current attitudes toward analgesic treatment for cancer pain in SEA, the ACE study explored patient & physician satisfaction with pain control in 6 SEA countries. Methods: This cross-sectional observational study included 465 adult outpatients prescribed analgesics for cancer pain for ≥1 month in Indonesia, Malaysia, Philippines, Singapore, Thailand, & Vietnam. Pain intensity, sleep disturbance, QoL, satisfaction with pain control, & physicians’ assessment of adequacy of analgesics were recorded via questionnaires. Current analgesic doses prescribed were extracted from medical records. Results: Most patients (84%) had stage 3 or 4 cancer. While 91% were prescribed opioids, mean reported pain intensity was 4.1 (0/no pain, 10/worst possible pain) & most had problems with sleep (55%) & QoL (problems with pain/discomfort [82%], usual activities [66%] & anxiety/depression [56%]). 60% of patients were satisfied with their pain control status & 30% found it acceptable. Physicians more often reported dissatisfaction with patients’ pain control status compared with patients (21% vs 10%). Patient-physician concordance in satisfaction with pain control was low (weighted Kappa 0.36; 95% CI 0.30-0.43). More than 1 in 4 physicians (29%) assessed prescribed analgesics to be “inadequate” for pain control. Median daily dose prescribed in oral morphine equivalents was 30 mg for both morphine & tramadol. Of the SEA countries included, prescribed doses of opioids were generally lower in Indonesia & higher in Vietnam. Conclusions: The results highlight the complexity of managing cancer pain in SEA. Despite unrelieved pain, sleep disturbance & QoL issues, many patients still reported satisfaction with pain control. Notably, physicians expressed dissatisfaction more frequently than patients. These findings suggest a need for all-round pain status assessment (including pain intensity, sleep disturbance, QoL) & improved patient-physician communication about analgesic treatment expectations, pain control & adverse effects.

scholarly journals A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Intensity Difference ◽  
Front Line ◽  
Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

scholarly journals Analgesic Effect of a 5% Lidocaine Patch in Patients With Opioid Treatment-Resistant Neuropathic Cancer Pain

2021 ◽  
Author(s):  
Jui-hung Tsai ◽  
I-Ting Liu ◽  
Pei-Fang Su ◽  
Ying-Tzu Huang ◽  
Ge-Lin Chiu ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Transdermal Patch ◽  
Analgesic Treatment ◽  
Opioid Treatment ◽  
Significant Difference

Abstract PurposeLimited efficacy has been observed when using morphine to treat neuropathic pain. Lidocaine patches reduce neuropathic pain in post-herpetic neuralgia, but their benefits for cancer-related neuropathic pain remain unclear. This study aimed to demonstrate a useful treatment for cancer-related neuropathic pain. The primary endpoint was pain intensity evaluated by the visual analog scale (VAS). The secondary endpoints were the pain relief score and the quality of analgesic treatment. MethodsWe assessed the efficacy and safety of lidocaine patches in patients experiencing neuropathic cancer pain. Terminal cancer patients with opioid treatment resistance participated in the 3-day study. ResultsThe results showed a statistically significant difference in the median VAS over three days (Kruskal-Wallis test, P<0.0001). The median VAS pain intensity from Day 1 to Day 3 was 4.0 with 95% C.I. (3.3, 5.0), 3.0 (2.5, 3.5) and 2.5 (2.0, 3.0), respectively. The difference between the median VAS pain intensities of any two days was statistically significant (Wilcoxon signed-rank test, P < 0.0001). There was no statistically significant difference in the pain relief score or the quality of analgesic treatment. ConclusionIn this study, the 5% lidocaine transdermal patch reduced the VAS pain intensity in neuropathic cancer patients with morphine resistance. The transdermal patch is generally useful and well-tolerated.

Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis

Pain Medicine ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. 2220-2227 ◽  
Author(s):  
Kazuhiro Hayashi ◽  
Takkan Morishima ◽  
Tatsunori Ikemoto ◽  
Hirofumi Miyagawa ◽  
Takuya Okamoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Gait Speed ◽  
Pain Catastrophizing ◽  
Hip Osteoarthritis ◽  
Cross Sectional ◽  
Japanese Orthopedic Association ◽  
Affected Side ◽  
Tertiary Center

AbstractObjective. Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. Design. Cross-sectional study conducted between June 2017 and February 2018. Setting. Tertiary center. Subjects. Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. Methods. QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. Results. The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. Conclusions. Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

What is stable pain control? A prospective longitudinal study to assess the clinical value of a personalized pain goal

2017 ◽  
Vol 31 (10) ◽  
pp. 913-920 ◽  
Author(s):  
Robin Fainsinger ◽  
Cheryl Nekolaichuk ◽  
Lara Fainsinger ◽  
Viki Muller ◽  
Lisa Fainsinger ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Pain Intensity ◽  
Classification System ◽  
Pain Control ◽  
Outcome Measure ◽  
Prospective Longitudinal Study ◽  
Goal Definition ◽  
Patient Reported ◽  
Prospective Longitudinal ◽  
Cognitively Intact

Background: A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. Aim: To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a research-based study definition for stable pain. Design: Prospective longitudinal descriptive study. Measures: The attending physician completed routine assessments, including a personalized pain goal and the Edmonton Classification System for Cancer Pain, and followed patients daily until stable pain control, death, or discharge. Stable pain for cognitively intact patients was defined as pain intensity less than or equal to desired pain intensity goal (personalized pain goal definition) or pain intensity ⩽3 (Edmonton Classification System for Cancer Pain study definition) for three consecutive days with <3 breakthroughs per day. Setting/participants: A total of 300 consecutive advanced cancer patients were recruited from two acute care hospitals and a tertiary palliative care unit. Results: In all, 231/300 patients (77%) had a pain syndrome; 169/231 (73%) provided a personalized pain goal, with 113/169 (67%) reporting a personalized pain goal ⩽3 (median = 3, range = 0–10). Using the personalized pain goal definition as the gold standard, sensitivity and specificity of the Edmonton Classification System for Cancer Pain definition were 71.3% and 98.5%, respectively. For mild (0–3), moderate (4–6), and severe (7–10) pain, the highest sensitivity was for moderate pain (90.5%), with high specificity across all three categories (95%–100%). Conclusion: The personalized pain goal is a feasible outcome measure for cognitively intact patients. The Edmonton Classification System for Cancer Pain definition closely resembles patient-reported personalized pain goals for stable pain and would be appropriate for research purposes. For clinical pain management, it would be important to include the personalized pain goal as standard practice.

Changes in Perceptions of Narcotic Analgesic Treatment and Quality of Life in Chronic Back Pain Patients

2017 ◽  
Vol 24 (2) ◽  
pp. 65
Author(s):  
Min-Wook Kim ◽  
Choong-Young Kim ◽  
Ji-Won Lee ◽  
Cheol-Hwan Kim ◽  
Ju-Sim Oh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Narcotic Analgesic ◽  
Analgesic Treatment ◽  
Pain Patients

scholarly journals Application of quality control circle in the treatment of moderate cancer pain in inpatients

2020 ◽  
Vol 50 (5) ◽  
pp. 581-585
Author(s):  
Yehuan Liu ◽  
Beibei Lin
Keyword(s):  
Quality Of Life ◽  
Quality Control ◽  
Cancer Pain ◽  
Pain Control ◽  
Management Tool ◽  
Control Group ◽  
Observation Group ◽  
Patients With Cancer ◽  
Significant Difference

Abstract Context Pain is one of the most common and intolerable symptoms in cancer patients. But cancer pain control is still negative in China. Objectives This paper explores the application of quality control circle in the treatment of cancer pain in inpatients to improve the quality of life of patients with cancer pain. Method Established a quality control circle group to analyze the current status of cancer pain control in inpatients with moderate cancer pain, set goals, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The Brief Pain Inventory was used to evaluate the cancer pain status of patients with cancer pain hospitalized before (January to April 2016) and after (September to December 2016) the implementation of quality control circle activities. Results The pain control effect of the observation group was significantly better than that of the control group. The mean (standard deviation) of pain severity and pain interference in the observation group were significantly lower than those in the control group (6.21 [2.86] vs 4.31 [2.25], 10.54 [4.10] vs 7.25 [3.77]). There was significant difference after the implementation of quality control circle (P &lt; 0.01). Conclusion Quality control circle activities are used to manage patients with cancer pain, to improve the situation of pain control and to improve the quality of life of patients. This management tool and method is worthy of clinical promotion and application.

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