Impact of Undertreatment of Cancer Pain With Analgesic Drugs on Patient Outcomes: A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan
Journal
Journal of Pain and Symptom Management
Journal Volume
54
Journal Issue
1
Date Issued
2017-07-01
Author(s)
Shen, Wen Chi
Chen, Jen Shi
Lee, Kuan Der
Chiou, Tzeon Jye
Sung, Yung Chuan
Rau, Kun Ming
Yen, Chia Jui
Liao, Yu Min
Liu, Ta Chih
Wu, Ming Fang
Lee, Ming Yang
Yu, Ming Sun
Hwang, Wen Li
Lai, Pang Yu
Chang, Cheng Shyong
Chou, Wen Chi
Hsieh, Ruey Kuen
Abstract
© 2017 American Academy of Hospice and Palliative Medicine Context Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). Objectives This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. Methods A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey. All patients completed a questionnaire based on the Brief Pain Inventory. Pain management index (PMI) was used to evaluate the adequacy of pain management. Possible clinical variables of patients with positive PMI were examined by univariate and multivariate logistic regressions. Results A total of 1659 (62.6%) outpatients had experienced some degree of pain; among these, 32.4% had negative PMI. Patients with a negative PMI score had significantly poor outcomes of QoL and a significantly higher tendency toward dissatisfaction with pain control by the physician and with the prescribed analgesic drugs. Female gender, primary tumor from breast, non–cancer-related cause of pain, and hospital locations from north Taiwan were independent variables that predicated patients with undertreatment of cancer pain. Most importantly, a forward trend of undertreatment of pain among patients who presented with lower prevalent rate of pain was observed. Conclusion One-third of Taiwanese outpatients experienced pain because of undertreatment. Awareness of the prevalence of undertreatment of cancer pain and identification of the vulnerable subjects may assist in enhancing patient care and improving patient's QoL.
Subjects
cancer | Pain | pain management index | pain survey | quality of life
cancer; Pain; pain management index; pain survey; quality of life
SDGs
Other Subjects
analgesic agent; analgesic agent; adult; aged; Article; bone cancer; brain cancer; breast cancer; Brief Pain Inventory; cancer pain; controlled study; cross-sectional study; digestive system cancer; female; head and neck cancer; health survey; human; liver cancer; lung cancer; major clinical study; male; multivariate logistic regression analysis; observational study; pain assessment; pain intensity; pain management index; patient care; prevalence; prospective study; Taiwan; thorax cancer; treatment outcome; ambulatory care; analgesia; cancer pain; clinical trial; middle aged; multicenter study; pain measurement; patient satisfaction; quality of life; questionnaire; very elderly; young adult; Adult; Aged; Aged, 80 and over; Ambulatory Care; Analgesics; Cancer Pain; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pain Management; Pain Measurement; Patient Satisfaction; Prevalence; Prospective Studies; Quality of Life; Surveys and Questionnaires; Taiwan; Treatment Outcome; Young Adult
Type
journal article