Psychological and behavioural predictors of pain management outcomes in patients with cancer

Jacobsen, Ramunė; Møldrup, Claus; Christrup, Lona Louring; Sjøgren, Per; Hansen, Ole

doi:10.1111/j.1471-6712.2010.00776.x

Cited by 19 publications

(12 citation statements)

References 49 publications

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“…Those previous studies had suggested that high pain score, less pain relief, and inadequate pain management were associated with higher barrier score; 11,24,30,31 however, those studies not only found higher barrier scores than our study found but also included patients who were not newly consulted or whose symptoms were already under interdisciplinary management.…”

contrasting

confidence: 85%

“…In contrast, studies conducted in other countries, including Denmark, 24 China (specifically Hong Kong), 25 Iceland, 26 Jordan, 27 and Lithuania, 28 have reported consistently higher barrier scores than those reported by that first validation study. Those higher scores are consistent with the results of our previous study, which focused on Korean cancer patients.…”

Section: Discussioncontrasting

confidence: 65%

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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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contrasting

confidence: 85%

Section: Discussioncontrasting

confidence: 65%

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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“…In Icelandic 9 as well as in Norwegian patients 10 the mean score was 2.2 -0.8; in Danish cancer patients it was 2.3 -0.7. 11 In the U.S. study of Gunnarsdottir and colleagues 4 the mean total score was lower (1.5 -0.7) compared to this study, with a mean total score of 2.4 -0.6 before the seminars, but comparable to the score after the seminar (1.6 -0.7).…”

Section: Barriers To Pain Management In Albania 759contrasting

confidence: 47%

Reducing the Barriers to Pain Management in Albania: Results from an Educational Seminar with Family Doctors

Xhixha

Rama

Radbruch

2013

Journal of Palliative Medicine

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Palliative care (PC) services are a very limited service in Albania and are provided mainly from the nonprofit sector (nongovernmental organizations [NGOs]) that cover about 30% of the demand. There are very few doctors and nurses qualified in PC and pain management. Training and education programs on opioid treatment do not exist and patients cannot access opioids easily. This study evaluated the attitudes of family doctors on pain assessment, management, and opioid usage before and after seminars on opioid pain management. The Barriers Questionnaire II (BQ-II) was used to evaluate attitudes towards pain management in 227 family doctors (general practitioners) working in the state primary health care system in both urban and rural areas. Data was collected before and after one-day seminars on opioids conducted in six cities located in all the major regions of the country. The response rate was 83.3%. Barriers were measured to be high in the participating physicians, with mean scores of 3 out of 5 or above for 10 of 27 items. The danger of addiction to pain medicines as well as the fear that many people with cancer would get addicted to pain medicine received the highest scores. At the end of the seminar barriers were significantly lower, with the total mean scores (with standard deviation) reduced from 2.4±0.6 to 1.6±0.7. High barriers to the use of opioids in family physicians in Albania were reduced significantly following a one-day training, demonstrating the effectiveness of the intervention. However, more research on the sustainability of the training effect is needed.

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“…1403-r) (International Narcotics Control Board 2017), this suggesting possible improvement in th treatment of pain in the near future. In some countries, inadequate treatment of pain may not be entirely due to the regulatory and governmental restrictions, but are more likely to be related to social, cultural, educational factors (Barry et al, 2010;Jacobsen, Moldrup, Christrup, Sjogren, & Hansen, 2010;O'Brien et al, 2017). For example, Italy since 2010 has one of the most compliant laws (Law 38/2010) with the WHO recommendations for pain management on a European scale (Chinellato et al, 2011); this notwithstanding, Italy still has a lower opioid use compared with other countries of Southern Europe.…”

Section: Discussionmentioning

confidence: 99%

Trends in the consumption of opioids for the treatment of severe pain in Europe, 1990–2016

Bosetti

Santucci

Radrezza

et al. 2018

European Journal of Pain

103

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Background Over the last decades, consumption of opioids for the treatment of pain increased steadily in the United States, Australia, and a few European countries. To date, no study has analysed time trends in opioid consumption across Europe. Methods We analysed data provided by International Narcotics Control Boards on the consumption of fentanyl, oxycodone, morphine, hydromorphone and pethidine in 40 European countries over the last decade. Trends in total opioid consumption from 1990 to 2016 in 22 selected European countries, the European Union (EU) as a whole, and, for comparison purpose, the United States, were analysed using the joinpoint regression analysis. Results In 2014–2016, opioid use was >10,000 defined daily doses for statistical purposes (s‐DDD) per 1,000,000 inhabitants die in Western/Northern countries, whereas it was <1000 s‐DDD in Southern/Eastern ones. In most European countries, opioid consumption increased to a great extent between 2004–2006 and 2014–2016; it rose from 6,477 to 8,967 s‐DDD (+38.4%) in the EU, and from 14,598 to 16,491 s‐DDD (+13%) in the United States. The increase in opioid use was steady since the early to mid‐1990s in most European countries and it slowed down after the mid‐ to late 2000s. In Denmark, Finland, France, Ireland, Switzerland, Poland and the EU, opioid use levelled off or declined over most recent years. Conclusions Consumption of opioid analgesics sharply increased in most of European countries since the early to mid‐1990s. This notwithstanding, in the mid‐2010s there was still a more than 10‐fold difference between the highest consumption in Western/Northern countries and the lowest one in Southern/Eastern countries. Significance This study provides an updated and comprehensive analysis of time trends and geographic variations in opioid consumption use across European countries over the last three decades.

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Psychological and behavioural predictors of pain management outcomes in patients with cancer

Cited by 19 publications

References 49 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

Reducing the Barriers to Pain Management in Albania: Results from an Educational Seminar with Family Doctors

Trends in the consumption of opioids for the treatment of severe pain in Europe, 1990–2016

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