MULTICENTER STUDY OF CANCER PAIN AND ITS TREATMENT IN FRANCE

Objective-To describe the treatment of cancer pain in France and to ev aluate the predictive factors for inadequate management. Design-Multic entre, representative cross sectional survey. Setting-20 treatment cen tres, including cancer centres, university hospitals, state hospitals, private clinics, and one homecare setting (in which patients are supp orted at home). Subjects-605 patients with cancer. Main measures-Patie nts rated prevalence and severity of pain and functional impairment re lated to pain. Doctors reported patients' cancer characteristic, perfo rmance status, pain severity, and analgesic drugs ordered. Results-57% (340/601) of patients with cancer reported pain due to their disease, and, of those with pain, 69% (224/325) rated their worst pain at a le vel that impaired their ability to function. 30% (84/279) were reporte d as receiving no drugs for their pain. Of the 270 patients in pain fo r whom information on treatment was available 51% (137/270) were not r eceiving adequate pain relief, according to an index based on the Worl d Health Organisation's guidelines. French doctors were found to under estimate the severity of their patients' pain. Younger patients, patie nts without metastatic disease, patients with a better performance sta tus, and patients who rated their pain as more severe than their docto rs did were at greater risk for undertreatment of their pain. Conclusi ons-In the light of the high prevalence and the severity of pain among patients with cancer, the assessment and treatment of cancer pain in France remain inadequate, emphasising the need for changes in patient care.