Barriers and Adherence to Pain Management in Advanced Cancer Patients

Mercadante, Sebastiano; Adile, Claudio; Tirelli, Walter; Ferrera, Patrizia; Penco, Italo; Casuccio, Alessandra

doi:10.1111/papr.12965

Cited by 14 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yates et al also found that the majority of patients stated addiction to medication as a barrier and believed in a real risk of addiction (Yates et al., 2002). Patients in the study of Mercadante et al identified constipation, nausea, vomiting and a feeling of tiredness and lethargy as worrying side effects of analgesics and avoided taking the medication (Mercadante et al., 2021). Opioids side effects and fear of addiction have also highlighted as attitudinal barriers by participants of the previous studies (Konstantis & Exiara, 2018; Kwon, 2014).…”

Section: Discussionmentioning

confidence: 99%

Barriers to cancer pain management from the perspective of patients: A qualitative study

et al. 2021

View full text Add to dashboard Cite

Aim The aim of this study was to explore the barriers to effective pain management in Iranian people with cancer. Design A qualitative descriptive design was used. Methods This qualitative descriptive study was performed on 14 people with cancer. Data were collected using semi‐structured interviews and analysed by Graneheim and Lundman's content analysis method. Results Four main categories emerged in relation to barriers to pain management from the perspective of people with cancer. Categories included 1) accepting and enduring divine pain, 2) negative attitudes towards the effectiveness of analgesics, 3) patients’ low knowledge of pain self‐management methods and 4) neglected pain management. Barriers to pain management are multidimensional in nature consisting of patients, healthcare providers and system components. Therefore, attempts should be focused on the education of patients and healthcare providers about pain management and eliminating the shortcomings of the healthcare system.

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers to cancer pain management from the perspective of patients: A qualitative study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The BAROC is an exploratory study investigating the relationship between psychological barriers and improvement in pain. It is important to use PROs, as pain improvement contributes to health-related quality of life 36–39. Psychological barriers may be influenced by opioid switching and analgesic use before the commencement of regular strong opioid analgesics use 18 36 40.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to use PROs, as pain improvement contributes to health-related quality of life 36–39. Psychological barriers may be influenced by opioid switching and analgesic use before the commencement of regular strong opioid analgesics use 18 36 40. These data are also being collected using the EDC system.…”

Section: Discussionmentioning

confidence: 99%

Psychological barriers to the use of opioid analgesics for treating pain in patients with advanced recurrent cancer (BAROC): protocol for a multicentre cohort study

et al. 2022

View full text Add to dashboard Cite

IntroductionOpioid analgesics are essential for treating cancer pain. However, patients are sometimes reluctant to use them because of concerns about addiction and dependence. Rapid pain relief following opioid administration may help overcome the psychological barriers to opioid analgesic use. This study aims to determine the relationship between psychological resistance to strong opioid analgesic use and pain amelioration speed in patients with advanced recurrent cancer.Methods and analysisThis ongoing, multicentre, observational study enrols patients aged 20 years or older with distant metastasis or advanced recurrent cancer receiving strong opioid analgesics for cancer pain for the first time. All participants, both inpatient and outpatient, were recruited from five Japanese hospitals. We are investigating the relationship between psychological barriers at the start of treatment and pain relief during the first week of treatment in these patients. The primary outcome is the Japanese version of the Barriers Questionnaire-II score at baseline. The secondary outcomes are the relationships between psychological barriers to strong opioid analgesic use and changes in pain over time. The participants are asked to fill out an electronic patient-reported outcome daily during the first week of treatment. The sample size was determined based on the number of patients in the year prior to study commencement who used strong opioid analgesics, met the eligibility criteria and could be expected to consent to participate in the study.Ethics and disseminationThe study protocol was approved by the ethics committee (approval ID B200600091) of Yokohama City University on 24 August 2020. The protocol has been reviewed by the institutional review boards at the four participating study sites. The results will be published in a peer-reviewed journal and will be presented at a relevant meeting.Trial registration numberUMIN000042443.

show abstract

“…Lack of knowledge among physician and patients, lack of adequate supply of opioids as well as limited access to palliative care services are the main causes of inadequate pain control in countries with limited resources [ 15 ]. Besides this, opioids-related adverse events remain the most important barriers that interfere with adherence to opioid analgesics [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Elhassan¹,

Mohammed²,

Omer³

et al. 2022

ecancer

View full text Add to dashboard Cite

Aim Data on the adverse events of opioids for cancer-related pain in Sudanese patients are limited. We conducted this study to evaluate the pattern and severity of adverse events of immediate release morphine, and tramadol used in the treatment of cancer-related pain. A secondary aim was to determine the response rate to opioids for pain control in cancer patients treated at the National Cancer Institute-University of Gezira (NCI-UG), Sudan. Methods This descriptive cross-sectional study was conducted at NCI-UG between 12 March 2019 and 12 May 2019. A pre-designed questionnaire was used to collect the clinical data of cancer patients on oral opioids for pain control during the study periods. Chi square test was applied to determine whether there is a significant association between the adverse events and the demographic/clinical variables. p value < 0.05 was considered statistically significant in all analyses. Results One-hundred and thirteen patients were screened in the study. Of these, three suffered from cognitive dysfunction and ten patients declined to participate in the study. Thus, 100 patients met the criteria for inclusion in this study. Breast cancer was the most frequent diagnosis (17%) followed by colorectal cancer (16%). The majority (91%) of patients had advanced or metastatic disease. The most frequently reported opioids-related adverse events were dry mouth (68%), constipation (61%), sedation (49%), nausea (31%) and vomiting (24%). Most of these symptoms were graded as mild to moderate and no patient had grade IV or V adverse events. Constipation and dry mouth were more frequent among patients received morphine compared to patients received tramadol ( p value < 0.005). Pain was controlled in 36% of patients, improved in 53% and not controlled in 11% of them. Conclusion This study shows a high prevalence of opioids-related adverse events. The majority of the opioids-related adverse events were grade I or grade II. There seem to be differences in the prevalence of opioids-related adverse events between patients receiving tramadol and those treated with morphine. Moreover, suboptimal pain control adds to the burden on already limited health resources. Therefore, the adequacy of cancer pain management in our setting should be systematically evaluated and effective cancer pain management programmes should be developed.

show abstract

Barriers and Adherence to Pain Management in Advanced Cancer Patients

Cited by 14 publications

References 25 publications

Barriers to cancer pain management from the perspective of patients: A qualitative study

Barriers to cancer pain management from the perspective of patients: A qualitative study

Psychological barriers to the use of opioid analgesics for treating pain in patients with advanced recurrent cancer (BAROC): protocol for a multicentre cohort study

Adverse events of opioids for cancer-related pain in a resource-limited setting: a cross-sectional study from Sudan

Contact Info

Product

Resources

About