CANCER PAIN SURVEY - PATIENT-CENTERED ISSUES IN CONTROL

It is widely believed that patients' reluctance to report pain and adh ere to treatment recommendations are significant barriers to cancer pa in control. However, few investigators have examined barriers to cance r pain management from the cancer patient's perspective. Ambulatory pa tients with cancer who had experienced cancer-related pain in the prev ious month or were currently taking analgesics for cancer pain control were asked to participate in this study. Information regarding (a) pa in assessment, (b) pain medication use, (c) concerns and barriers to c ompliance, (d) communication patterns regarding pain and pain control, and (e) demographics were collected during a 10-min structured interv iew. Approximately 20% of patients with a current cancer diagnosis who were approached reported that they had experienced pain or taken anal gesic drugs during the preceding month. Eighty-eight percent of these patients ranked their pain as five or greater (scale, 0-10), and 81 % reported impaired function due to pain. Major barriers to effective tr eatment included forgetfulness, the belief that pain should be tolerat ed concerns about side effects, and fear and disdain of dependence, ad diction, and tolerance. One-third of patients felt that their pain cou ld not be better controlled than it currently was. Patients reported f requent communication regarding pain and pain control with physicians (52 %), nurses (41 %), and pharmacists (17 %). The low pain prevalence was called with high pain intensity and associated dysfunction, appea rs to DP a reflection of patient's unwillingness to report pain of mil d to moderate intensity. In addition to previously recognized factors, stoicism and fatalism represent significant barriers to cancer pain c ontrol. (C) U.S. Cancer Pain Relief Committee, 1998.