Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report

Kwon, Jung Hye; Oh, Sung Yong; Chisholm, Gary B.; Lee, Jung Ae; Lee, Jae Jin; Park, Keon Woo; Nam, Seung Hyun; Song, Hun Ho; Lee, Keehyun; Zang, Dae Young; Kim, Ho Young; Choi, Dae Ro; Kim, Hyo Jung; Kim, Jung Han; Jung, Joo Young; Jang, Geundoo; Kim, Hyeong Su; Won, Ji Yun; Bruera, Éduardo

doi:10.1007/s00520-012-1646-x

Cited by 23 publications

(22 citation statements)

References 33 publications

(49 reference statements)

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“…Our previous study, which looked at a population of Korean cancer patients, found an association between high barriers scores in cancer pain management and depression; 17 however, the current study found no significant association in this respect (see Table 5). This discrepancy might be explained by the fact that these two studies each used different tools to measure depression: the Beck Depression Inventory for the Korean population and the depression section of the ESAS for the North American population.…”

contrasting

confidence: 51%

“…Those higher scores are consistent with the results of our previous study, which focused on Korean cancer patients. 17 Comparing to the Korean study, which was conducted in an oncology clinic, 17 differences in results might be attributed to differences in the study populations, such as in race, clinical characteristics, and medical services received, or to the relatively lower pain management barrier scores in the current study (see Table 6). However, the most important difference might be the increased time that the palliative care team spends communicating with patients in a palliative care clinic compared with health care provider-patient communication in regular oncology clinics, where the discussion must focus on cancer management and planning in addition to pain and symptom management.…”

Section: Discussionmentioning

confidence: 88%

“…1 Our previous study in a Korean cancer patient population showed an association between depression and high barriers to pain management scores. 17 Moreover, results of a recent study suggested improvement in depression to be a predictor of improvements in cancer pain levels. 18 Identifying the factors associated with high patient-reported barriers to adequate pain management would improve the multimodal management of pain in cancer patients.…”

mentioning

confidence: 99%

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Experience of Barriers to Pain Management in Patients Receiving Outpatient Palliative Care

Kwon

Hui

Chisholm

et al. 2013

Journal of Palliative Medicine

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Background: Patient-reported barriers are an important obstacle to cancer pain management. For effective pain management, exploring patient-reported barriers and related factors is important. Objectives: The study's objective is to determine factors associated with patient-reported barriers to cancer pain management. Method: We conducted a secondary analysis of data from a prospective observational study examining opioid adherence in palliative care outpatients. We evaluated the association between high score on patient-reported barriers to cancer pain management, on the Barriers Questionnaire II (BQ-II), and patients' race, sex, smoking history, pain intensity, opioid dose, and depression. Results: Of 196 patients evaluated (median age 55 years), 147 (75%) were white, 41 (21%) had gastrointestinal cancer, and 121 (62%) were receiving anticancer treatment when data were collected. The median pain score was 4 (interquartile range [IQR] 3-7); 98% were receiving strong opioids; and 63% were satisfied with their pain medication. The median Edmonton symptom assessment scale (ESAS) depression score was 1 (IQR 0-3). Mean (SD) BQ-II scores were 1.8 (0.9) for physiologic effects, 1.6 (0.9) for fatalism, 0.9 (0.9) for communication, 2.3 (1.1) for harmful effects, and 1.7 (0.8) in total. Only racial differences were associated with high total BQ-II score in multivariable analysis (R2 = 0.05, overall F test significance = 0.02). Pain related factors including opioids dose, pain intensity, and satisfaction were not associated with high BQ-II score. Conclusion: Patients receiving palliative care expressed low barriers to pain control. There were minimal associations of BQ-II score with demographics and clinical factors.

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confidence: 51%

Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

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Experience of Barriers to Pain Management in Patients Receiving Outpatient Palliative Care

Kwon

Hui

Chisholm

et al. 2013

Journal of Palliative Medicine

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“…31,44 A large recent national study 17 did not find any association between provider-assessed patient emotional distress and pain in a diverse sample of cancer patients. However, some evidence suggests that providers may underestimate depression or emotional distress among cancer patients.…”

Section: Discussionmentioning

confidence: 96%

Is Race/Ethnicity Related to the Presence or Severity of Pain in Colorectal and Lung Cancer?

Martinez

Snyder

Malin

et al. 2014

Journal of Pain and Symptom Management

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Context Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis. Objectives To examine patterns of disparities in cancer pain by evaluating differences by race/ethnicity in the odds of reporting pain and in pain severity, controlling for key patient-level covariates. Methods This study used data from a nationally representative cohort of colorectal and lung cancer patients. Multivariable logistic regression was conducted to examine the relationship between race/ethnicity and reporting pain. Multivariable linear regression was then conducted, among those who reported pain, to determine differences in pain severity by race/ethnicity. Results The cohort included 5761 individuals (14% black, 7% Hispanic/Latino, 6% Asian or Pacific Islander, and 3% multiracial), among whom 48% reported pain. The adjusted odds of reporting differed only for multiracial patients, who were more likely to report pain than whites (odds ratio: 1.54; P = 0.036). However, among those with pain, severity was higher for black patients (β = 6.6; P ≤ 0.001) and multiracial patients (β = 4.5; P = 0.036) relative to white patients. Lower educational attainment, depressed affect, and lower levels of wealth also were associated with higher pain severity. Conclusion Although the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to focus on reported severity and patient-level factors.

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“…9 Depression is also found to be a significant barrier to manage pain, underscoring the importance of managing depression in order to improve pain. 10 According to the National Comprehensive Cancer Network, distress is an "unpleasant experience of a mental, physical, social, or spiritual nature." It can affect the way an individual thinks, feels, or acts and can make coping more difficult.…”

Section: Psychological Painmentioning

confidence: 99%

Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

Brant¹

2017

Palliat Med Hosp Care Open J

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Pain is a significant symptom in patients with chronic and life-threatening illness. While pain is traditionally thought of as a physiological experience, total pain recognizes the interplay of psychological, cognitive, social, spiritual, and cultural factors that influence the pain perception and total experience. Comprehensive pain assessment and management are foundational goals within the scope of palliative care, and optimal management depends on addressing each domain of the total pain experience. An overview of the total pain experience is provided, and clinicians should consider psychological, cognitive, social, spiritual, and cultural aspects in assessing pain. Pain management also addresses all domains, and suggestions are provided which address pain management barriers and challenges. First, patients should be educated about the benefits of pain management and importance to adhere to the plan of care. Second, healthcare professionals need education in order to manage pain properly and should adhere to internationally recognized evidence-based guidelines to provide care. Third, barriers to overcome system issues need to be addressed, such as working with governments and Ministries of Health to increase opioid availability for those in need and to ensure that patients can have access to opioids whether in the hospital, home, city, or rural area. While pain is a complex phenomenon, a comprehensive management plan can alleviate suffering for patients and their families.

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Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report

Cited by 23 publications

References 33 publications

Experience of Barriers to Pain Management in Patients Receiving Outpatient Palliative Care

Experience of Barriers to Pain Management in Patients Receiving Outpatient Palliative Care

Is Race/Ethnicity Related to the Presence or Severity of Pain in Colorectal and Lung Cancer?

Holistic Total Pain Management in Palliative Care: Cultural and Global Considerations

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