ONCOLOGISTS AND PRIMARY-CARE PHYSICIANS ATTITUDES TOWARD PAIN CONTROLAND MORPHINE PRESCRIBING IN FRANCE

Citation
F. Larue et al., ONCOLOGISTS AND PRIMARY-CARE PHYSICIANS ATTITUDES TOWARD PAIN CONTROLAND MORPHINE PRESCRIBING IN FRANCE, Cancer, 76(11), 1995, pp. 2375-2382
Citations number
28
Categorie Soggetti
Oncology
Journal title
CancerACNP
ISSN journal
0008543X
Volume
76
Issue
11
Year of publication
1995
Pages
2375 - 2382
Database
ISI
SICI code
0008-543X(1995)76:11<2375:OAPPAT>2.0.ZU;2-G
Abstract
Background. Two representative samples of primary care physicians (N = 600) and medical oncologists (N = 300) in France were surveyed about their attitudes toward and knowledge about cancer pain management. Met hods. The survey was conducted by telephone with a questionnaire based on a model developed by the University of Wisconsin-Madison Pain Rese arch Group. It was designed to assess physicians' estimates of the pre valence of pain among patients with cancer, their practice in prescrib ing analgesics, their training in cancer pain management, and the qual ity of care received by cancer patients in their own practice and in F rance. Results. Barriers to adequate cancer pain management are preval ent and consistently more common among primary dare physicians than am ong medical oncologists. Although 85% of primary care physicians and 9 3% of medical oncologists express satisfaction with their own ability to manage cancer pain, 76% of primary care physicians and 50% of medic al oncologists report being reluctant to prescribe morphine for cancer pain. Both groups cite fear of side effects as their main reason to h esitate to prescribe morphine, Concerns about the risk of tolerance (o dds ratio [OR], 1.15-2.52), perceptions that other effective drugs are available (OR, 1.11-2.41), perceptions that morphine has a poor image in public opinion (OR, 0.96-2.07), and the constraints of prescriptio n forms (OR, 1.12-2.26) contribute significantly to physicians' infreq uent prescription of morphine, as are being female (OR, 1.01-2.03) and being an older oncologist (OR, 1.09-2.51). Conclusions. This study (1 ) confirms the existence among French physicians of attitudinal barrie rs and knowledge deficits previously reported in other countries that can impede cancer pain management, (2) identifies new barriers to the proper prescription of morphine for cancer pain control, and (3) revea ls discrepancies in physicians' attitudes and knowledge about pain con trol which suggest a need for the systematic evaluation of cancer pati ents' care.