MANAGEMENT OF PAIN IN TERMINALLY ILL PATIENTS - PHYSICIAN REPORTS OF KNOWLEDGE, ATTITUDES, AND BEHAVIOR

Physician knowledge, attitudes, and reported prescribing behaviors tow ard pain management in terminally ill patients was surveyed among prim ary care physicians (PCPs) and oncologists in a southern urban county. Response rates were 64% for PCPs and 100% for oncologists. The effect s of knowledge and attitudes on reported behavior were analyzed after accounting for physician demographics, training, and experiences. Onco logists' knowledge and attitudes were close to ideal and behaviors les s so. PCPs' knowledge was worse than oncologists, and attitudes and be haviors were even less optimal. Reported behaviors among PCPs correlat ed somewhat with attitudes, less with background factors, and rarely w ith knowledge. In multivariate analysis, demographic and experiential factors explained more of selected behaviors than attitudes or knowled ge. However, all variables combined left the majority of variation in behaviors unexplained. Physician continuing education will not effect significant behavioral changes in the care of terminally ill patients solely by the traditional approach of attempting to modify knowledge a nd attitudes. (C) U.S. Cancer Pain Relief Committee, 1998.