A multicentre survey of pain management in cancer patients and physicians attending radiotherapy clinics in Shandong Province, China

Abstract

Objective To obtain a better understanding of the prevalence and management of pain in patients undergoing radiotherapy for cancer in Shandong Province, China. Methods This cross-sectional study used a questionnaire during face-to-face interviews to collect data from physicians and patients regarding the recognition, prevalence and treatment of pain during the waiting period before commencement of radiotherapy and during the radiotherapy period. Physicians and patients were recruited from 10 tertiary Class A hospitals across Shandong Province, China. Results A total of 184 patients and 87 physicians were recruited to the study. During the waiting period, pain was reported by the physicians according to their experience to affect 26.0% of patients, which almost agreed with the patients’ data (36.5%; 160 of 438). During the radiotherapy period, there was a significant difference in the reported prevalence of pain during the radiotherapy period between the physicians’ data (23.0%) based on their experience and the patients’ data (84.1%; 169 of 201 patients). The majority of physicians (98.9%; 86 of 87) agreed to the use opioids for pain management and 90.8% (79 of 87) were satisfied with the analgesic effect, but more than half of the patients who received pain treatment reported inadequate analgesia. Conclusion There was a high incidence of cancer pain, but insufficient assessment, inadequate treatment and inadequate education about pain in both the waiting and radiotherapy periods.

Knowledge, Practices, and Perceived Barriers in Cancer Pain Management at Oncology Units: A Cross-Sectional Survey of Medical Staff in China

“…These were similar to those reported in previous studies in China. 25 , 26 , 28 , 29 This indicated that the WHO and NCCN guidelines for cancer pain are widely used in China and considered as the primary references for the treatment of cancer pain. In China, many efforts have been taken to improve pain management.…”

“…This is similar to the findings from previous studies. 22 , 25 , 26 This suggested a gap between existing treatment guidelines and real-world clinical practice. Thus, hospitals should provide timely and continuous education and training for updated guidelines to the medical staff, particularly for opioid dose calculation and conversion from oral to parenteral routes of administration.…”

“…At present, in China, some studies also have investigated the factors among medical staff that influence the treatment of cancer pain. [26][27][28] For instance, in a multi-center survey in Shandong, China, a high incidence of cancer pain was attributed to insufficient assessment, treatment, and patient education on cancer pain. 26 However, these studies have a relatively small sample size (mostly limited to certain areas), and focus on a single medical profession, either physicians or nurses.…”

“…[26][27][28] For instance, in a multi-center survey in Shandong, China, a high incidence of cancer pain was attributed to insufficient assessment, treatment, and patient education on cancer pain. 26 However, these studies have a relatively small sample size (mostly limited to certain areas), and focus on a single medical profession, either physicians or nurses. Therefore, a large-scale investigation of knowledge and practices among medical staff for cancer pain management in China is needed.…”