Cognition and Sociodemographic Determinants for Effective Pain Control in Patients with Cancer Pain: a Cross-sectional Survey in China

Xiao-fang Shangguan , Zao-qin Yu , Lu Ji , Yang-yang Chen , Hong-yan Wu , Rui Huang , Cheng-Liang Zhang

Current Medical Science ›› 2020, Vol. 40 ›› Issue (2) : 249 -256.

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Current Medical Science ›› 2020, Vol. 40 ›› Issue (2) : 249 -256. DOI: 10.1007/s11596-020-2167-3
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Cognition and Sociodemographic Determinants for Effective Pain Control in Patients with Cancer Pain: a Cross-sectional Survey in China

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Abstract

This cross-sectional study aimed to investigate cancer patients’ cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in China. In seven tertiary hospitals across China, 372 patients experiencing cancer pain were surveyed through a self-designed questionnaire to assess the factors associated with effective pain control. Patients’ demographic data and pain control-related factors were recorded. Cluster sampling and binary logistic regression models were used to investigate the association between predictive factors and effective pain control. The survey showed that the majority of the patients were more than 45 years old (76.3%), and 64.4% had an average annual income of more than 20 000 RMB. One-third of the patients suffered from cancer pain for more than 3 months, and 75.1% received professional guidance during medication. The barriers to pain control for patients included preference to enduring pain and refusing analgesics (62.9%), negligence towards drug usage (28.5%), concerns about the addiction (48.2%) and adverse reaction (56.4%). The average annual family income, professional guidance, knowledge of pain medication, adherence to analgesics, and concerns about addiction to analgesics were significantly correlated to the effect of patients’ pain control. The study presents major barriers to optimal pain control among patients with cancer in China. Our findings suggest that educational programs and medical insurance reimbursement support from the government are urgently needed to overcome the cognitive barriers toward effective pain management and to relieve the economic burden among patients with cancer pain in China.

Keywords

cancer pain / cognition / sociodemographic determinants / pain control / pain management

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Xiao-fang Shangguan, Zao-qin Yu, Lu Ji, Yang-yang Chen, Hong-yan Wu, Rui Huang, Cheng-Liang Zhang. Cognition and Sociodemographic Determinants for Effective Pain Control in Patients with Cancer Pain: a Cross-sectional Survey in China. Current Medical Science, 2020, 40(2): 249-256 DOI:10.1007/s11596-020-2167-3

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References

[1]

van den Beuken-vanE M, de RijkeJM, KesselsAG, et al.. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol, 2007, 18(9): 1437-1449

[2]

van den Beuken-vanE M, HochstenbachLM, JoostenEA, et al.. Update on prevalence of pain in patients with cancer: Systematic review and meta-analysis. J Pain Symptom Manage, 2016, 51(6): 1070-1090

[3]

InoueS, KobayashiF, NishiharaM, et al.. Chronic pain in the Japanese community-prevalence, characteristics and impact on quality of life. PLoS One, 2015, 10(6): e0129262

[4]

RauKM, ChenJS, WuHB, et al.. The impact of pain control on physical and psychiatric functions of cancer patients: a nation-wide survey in Taiwan. Jpn J Clin Oncol, 2015, 45(11): 1042-1049

[5]

KnaulFM, FarmerPE, KrakauerEL, et al.. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet, 2018, 391(10128): 1391-1454

[6]

Cancer pain relief. Geneva: World Health Organization; 1986.

[7]

GaoW, GullifordM, BennettMI, et al.. Managing cancer pain at the end of life with multiple strong opioids: a population-based retrospective cohort study in primary care. PLoS One, 2014, 9(1): e79266

[8]

CaraceniA, HanksG, KaasaS, et al.. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol, 2012, 13(2): 58-68

[9]

JaraC, Del BarcoS, GrávalosC, et al.. SEOM clinical guideline for treatment of cancer pain (2017). Clin Transl Oncol, 2018, 20(1): 97-107

[10]

Lara-SolaresA, AhumadaO M, Basantes PinosAL, et al.. Latin-American guidelines for cancer pain management. Pain Manag, 2017, 7(4): 287-298

[11]

SwarmRA, PaiceJA, AnghelescuDL, et al.. Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2019, 17(8): 977-1007

[12]

ShuteC. The challenges of cancer pain assessment and management. Ulster Med J, 2013, 82(1): 40-42

[13]

MackKA, JonesCM, BallesterosMF. Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas-United States. Am J Transplant, 2017, 17(12): 3241-3252

[14]

HamiehNM, AkelR, AnoutiB, et al.. Cancer-Related Pain: Prevalence, Severity and Management in a Tertiary Care Center in the Middle East. Asian Pac J Cancer Prev, 2018, 19(3): 769-775

[15]

VuongS, PulenzasN, DeAngelisC, et al.. Inadequate pain management in cancer patients attending an outpatient palliative radiotherapy clinic. Support Care Cancer, 2016, 24(2): 887-892

[16]

ShenWC, ChenJS, ShaoYY, et al.. Impact of Undertreatment of Cancer Pain with Analgesic Drugs on Patient Outcomes: A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan. J Pain Symptom Manage, 2017, 54(1): 55-65

[17]

GrecoMT, RobertoA, CorliO, et al.. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol, 2014, 32(36): 4149-4154

[18]

SharkeyL, LoringB, CowanM, et al.. National palliative care capacities around the world: results from the World Health Organization Noncom-municable Disease Country Capacity Survey. Palliat Med, 2018, 32: 106-113

[19]

Ministry of Health of the People’s Republic of China.. Norms for cancer pain treatment, 2011

[20]

XiaZ. Cancer pain management in China: current status and practice implications based on the ACHEON survey. J Pain Res, 2017, 10: 1943-1952

[21]

JamisonRN, SheehanKA, ScanlanE, et al.. Beliefs and attitudes about opioid prescribing and chronic pain management: survey of primary care providers. J Opioid Manag, 2014, 10(6): 375-382

[22]

AlnajarMK, DarawadMW, AlshahwanSS, et al.. Knowledge and Attitudes Toward Cancer Pain Management Among Nurses at Oncology Units. J Cancer Educ, 2019, 34(1): 186-193

[23]

GunnarsdottirS, DonovanHS, SerlinRC, et al.. Patient-related barriers to pain management: the Barriers Questionnaire II (BQ-II). Pain, 2002, 99(3): 385-396

[24]

PotterVT, WisemanCE, DunnSM, et al.. Patient barriers to optimal cancer pain control. Psychooncology, 2003, 12(2): 153-160

[25]

KonstantisA, ExiaraT. Family caregiver beliefs and barriers to effective pain management of cancer patients in home care settings. J BUON, 2018, 23(7): 144-152

[26]

LeeBO, LiuY, WangYH, et al.. Mediating effect of family caregivers’ hesitancy to use analgesics on homecare cancer patients’ analgesic adherence. J Pain Symptom Manag, 2015, 50(6): 814-821

[27]

WangNY, LiuYM, ZhaoHJ, et al.. The treatment effect analysis of related factors effecting chronic pain patients with moderately sever pain. Chin J Clin Oncol, 2014, 41(10): 655-658

[28]

YanjunS, ChangliW, LingW, et al.. A survey on physician knowledge and attitudes towards clinical use of morphine for cancer pain treatment in China. Support Care Cancer, 2010, 18(11): 1455-1460

[29]

LiuW, XieS, YueL, et al.. Investigation and analysis of oncologists’ knowledge of morphine usage in cancer pain treatment. Onco Targets Ther, 2014, 7: 729-737

[30]

ZhangQ, YuC, FengS, et al.. Physicians’ Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China. Pain Med, 2015, 16(11): 2195-203

[31]

RobinsonJP, DansieEJ, WilsonHD, et al.. Attitudes and Beliefs of Working and WorkDisabled People with Chronic Pain Prescribed Long-Term Opioids. Pain Med, 2015, 16(7): 1311-1324

[32]

ClearyJ, PowellRA, MuneneG, et al.. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Africa: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol, 2013, 24(Suppl11): xi14-xi23

[33]

LiangSY, ChenKP, TsaySL, et al.. Relationship between belief about analgesics, analgesic adherence and pain experience in taiwanese cancer outpatients. Asian Pac J Cancer Prev, 2013, 14(2): 713-716

[34]

Al-AtiyyatNMH, VallerandAH. Patient-related attitudinal barriers to cancer pain management among adult Jordanian patients. Eur J Oncol Nurs, 2018, 33: 56-61

[35]

OldenmengerWH, SmittPAS, van DoorenS, et al.. A systematic review on barriers hindering adequate cancer pain management and interventions to reduce them: a critical appraisal. Eur J Cancer, 2009, 45(8): 1370-1380

[36]

MeghaniSH, ThompsonAM, ChittamsJ, et al.. Adherence to analgesics for cancer pain: a comparative study of African Americans and Whites using an electronic monitoring device. J Pain, 2015, 16(9): 825-835

[37]

WangZ, ChangR L, YB, et al.. Evaluation of Need and Distribution of National Essential Medicines List in Village Clinics: A Cross-sectional Study Based on the Perspective of Village Doctors in China. Curr Med Sci, 2019, 39(4): 663-669

[38]

GunnarsdottirS, SerlinRC, WardS. Patient-related barriers to pain management: the icelandic barriers questionnaire II. J Pain Symptom Manag, 2005, 29(3): 273-285

[39]

GunnarsdottirS, SigurdardottirV, KlokeM, et al.. A multicenter study of attitudinal barriers to cancer pain management. Support Care Cancer, 2017, 25(11): 3595-3602

[40]

TzengJI, ChangCC, ChangHJ, et al.. Assessing analgesic regimen adherence with the Morisky Medication Adherence Measure for Taiwanese patients with cancer pain. J Pain Symptom Manag, 2008, 36(2): 157-166

[41]

ChouWC, ChenJS, HungCY, et al.. A nationwide survey of adherence to analgesic drugs among cancer patients in Taiwan: prevalence, determinants, and impact on quality of life. Support Care Cancer, 2019, 27(8): 2857-2867

[42]

ImEO, LiuY, KimYH, et al.. Asian American cancer patients’ pain experience. Cancer Nurs, 2008, 313: E17-E23

[43]

KimYC, AhnJS, CalimagMMP, et al.. Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries. Cancer Med, 2015, 4(8): 1196-1204

[44]

GreenC H-, JohnsonT. The adequacy of chronic pain management prior to presenting at a tertiary care pain center: the role of patient socio-demographic characteristics. J Pain, 2010, 11(8): 746-754

[45]

LouF, ShangS. Attitudes towards pain management in hospitalized cancer patients and their influencing factors. Chin J Cancer Res, 2017, 29(1): 75-85

[46]

XuX, OuM, XieC, et al.. Pain Acceptance and Its Associated Factors among Cancer Patients in Mainland China: A Cross-Sectional Study. Pain Res Manag, 2019, 2019: 9458683

[47]

JacobsenR, MoldrupC, ChristrupC, et al.. Patient-related barriers to cancer pain management: a systematic exploratory review. Scand J Caring Sci, 2009, 23: 190-208

[48]

ZengD, LiK, LinX, et al.. Attitudinal Barriers to Pain Management and Associated Factors Among Cancer Patients in Mainland China: Implications for Cancer Education. J Cancer Educ, 2020, 35(2): 284-291

[49]

RustoenT, ValebergBT, KolstadE, et al.. The PRO-SELF((c)) Pain Control Program improves patients’ knowledge of cancer pain management. J Pain Symptom Manage, 2012, 44(3): 321-330

[50]

AdamR, BondC, MurchieP. Educational interventions for cancer pain. A systematic review of systematic reviews with nested narrative review of randomized controlled trials. Patient Educ Couns, 2015, 98(3): 269-282

[51]

PadrnosL, BennettR, KosiorekH, et al.. Living with Cancer: an Educational Intervention in Cancer Patients Can Improve Patient-Reported Knowledge Deficit. J Cancer Educ, 2018, 33(3): 653-659

[52]

HoltzmanAL, WilliamsJP, HutchinsonDF, et al.. Improving Patient-reported Pain During Radiotherapy Through Nurse Involvement and Patient Education. Am J Clin Oncol, 2018, 41(10): 1028-1030

[53]

PrevostV, HeutteN, LeconteA, et al.. Effectiveness of a therapeutic patient education program in improving cancer pain management: EFFADOL, a stepped-wedge randomised controlled trial. BMC Cancer, 2019, 19(1): 673

[54]

ZhouL, LiuXL, TanJY, et al.. Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: a systematic review. International Nursing Review. Int Nurs Rev, 2015, 62(2): 218-230

[55]

WangY, HuangH, ZengY, et al.. Pharmacist-led medication education in cancer pain control: A multicentre randomized controlled study in Guangzhou, China. J Int Med Res, 2013, 41(5): 1462-1472

[56]

EdwardsZ, ZieglerL, CraigsC, et al.. Pharmacist educational interventions for cancer pain management: a systematic review and meta-analysis. Int J Pharm Pract, 2019, 27(4): 336-345

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