Patients' associations with regard to analgesic drugs and their forms for application – a pilot study

Abstract

Patients' and caregivers' fear of addiction to and concern about side effects of morphine have been found to be among the major barriers to adequate pain relief in cancer patients. In contrast, the transdermal administration of opioids by means of fentanyl patches does not seem to evoke such fears. In a qualitative study, 60 patients in our outpatient pain clinic recorded up to five associations with a list of diseases, drugs and administration routes. Cancer and AIDS were associated most often with death, followed by suffering, anxiety and hopelessness. Migraine was associated predominantly with pain and other physical symptoms. Aspirin was associated less with pain in general than with headache and, sometimes, specifically with alcohol or hangover. Morphine was associated predominantly with pain and pain relief, but fears of intoxication, abuse and addiction and concerns about side effects were frequently named. Major differences were evident from the associations with the different routes of administration. The word 'pill' was mostly associated with contraception. Associations with 'tablets' were more pharmacological in nature, and side effects were frequently named. Patches were associated with wounds, cuts, bruises, and blisters and with protection. Some associations with patches were related to comfort. Injections and infusions were associated with physicians or the hospital environment. In conclusion, patients expressed major differences in their perceptions of the different drugs and routes of administration. The results may give a first hint that minor cultural differences even between western European countries may lead to major differences in prescribing habits and treatment regimens.

Development, Reliability, and Validity of a New Preference and Satisfaction Questionnaire

“…Because great care was taken in adapting the questionnaire into multiple languages using the Task Force for Translation and Cultural Adaptation recommendations [32] followed by cognitive debriefs in the respective countries, the differences observed between countries are unlikely to be caused by wording bias. We speculate that the observed differences between countries may be explained by small sample sizes (n Ͻ 70 for 12 of 18 languages) or may reflect cultural preferences for one mode of administration versus another [42][43][44]. There is no a priori reason that preference for one modality over another should differ by the same magnitude across cultures.…”

Assoziationen von Tumorpatienten und deren Behandelnden zu den Themen Ernährung und Appetit

“…Ein Anwendungsbeispiel dieser Methodik in der qualitativen Forschung in der Palliativmedizin ist die Untersuchung der Wahrnehmung und Akzeptanz von Medikamenten und deren Anwendungsweisen von Radbruch et al [21]. Dabei wiesen die in dieser Studie erfassten unterschiedlichen Assoziationen zu verschiedenen Anwendungsarten von Schmerzmitteln darauf hin, dass kleine kulturelle Unterschiede zwischen westeuropäischen Ländern zu einer deutlich unterschiedlichen Anwendungsweise dieser Medikamente führen.…”

Individualizing pain therapy with opioids: The rational approach based on pharmacogenetics and pharmacokinetics

“…The “opioid‐phobia” includes the fear of side effects (such as a respiratory depression) and dependence (Redmond et al, 1997, Maltoni, 2008). It is well known that patients are scared by the words “opioids” and “morphine”: indeed fentanyl is often better accepted than morphine as the name is not recognized as an opioid (Radbruch et al, 2002).…”