TREATMENT OF TERMINAL CANCER PAIN IN FRANCE - A QUESTIONNAIRE STUDY

Compared with other European countries, French laws and restrictions c oncerning the use of opioids are of medium severity only. Still, toget her with Germany, Belgium and Spain, France belongs to the group of co untries with a low national consumption of morphine, calculated by the International Narcotics Control Board of United Nations. In order to elucidate the current practice of French physicians treating cancer pa in, a questionnaire study was carried out, using the nationwide regist er of general practitioners and specialists of a pharmaceutical compan y. The knowledge of the principles and methods of cancer pain treatmen t were evaluated with 9 open and 19 multiple-choice questions. The abi lity of the physicians to apply their knowledge in practice was evalua ted by analyzing their suggested treatment of 3 illustrative case hist ories. The favourite drugs in treating cancer pain were strong opioid agonists, suggested by 25% of the general practitioners and 44% of the specialists for a typical cancer pain patient. The recommended daily doses of opioids were mostly far below the level generally accepted in palliative care. The drug of choice for metastatic bone pain was a co mbination of paracetamol and codeine, chosen by a third of the general practitioners. Consequently, only 10% and 21% of the treatment sugges tions were regarded as adequate. Ninety-two percent of the physicians experienced difficulties in the treatment of cancer pain, inefficacy o f treatment being the most important problem.