MANAGEMENT OF CANCER PAIN IN DENMARK - A NATIONWIDE QUESTIONNAIRE SURVEY

A questionnaire survey was carried out with the aim of evaluating know ledge about and practice of cancer pain treatment in Denmark. A questi onnaire was sent out to a 10% random sample of Danish physicians. Of t hese 1411 physicians, 1068 (76%) returned the questionnaires and after exclusion of those doctors who never treated cancer patients, 577 (54 %) were analyzed. Their knowledge of the principles and pratice of can cer pain treatment was evaluated by means of 14 multiple-choice and op en questions. Their ability to apply their knowledge in practice was e valuated by analyzing their suggested treatment of 3 simulated patient cases. The results show that a vast majority (97%) of the physicians were prepared to use opioids conventionally administered for severe pa in and that 39% reported the use of other treatment modalities (psycho logical treatment, antineoplastic therapy, transcutaneous nerve stimul ation/acupuncture, etc.). Ninety-seven percent of the physicians recog nized difficulties in cancer pain treatment, the most frequent being s ide effects of drugs and inadequate pain relief. Seventy-five percent considered that their knowledge about pain treatment was fair or bette r. The overall evaluation of the proposals for pain treatment of the p atient cases was primarily based on drug therapy. Adequate doses, corr ect dose intervals and selection of drugs, routes of administration an d other treatments were the requirements for satisfactory answers. It appears that the majority the physicians could treat both pain from bo ne metastasis (75%) and visceral pain (78%) satisfactorily, while very few suggested co-analgesics for neuropatic pain conditions (20%). Old er physicians performed less well than their younger colleagues. Basic pain treatment skills have been acquired by the Danish physicians but , in the future, emphasis should be placed on the treatment of neuropa thic pain with co-analgesics and the management of opioid side effects .