Minority cancer patients and their providers - Pain management attitudes and practice

BACKGROUND. The goals of the current studies were: 1) to determine the pain treatment needs of socioeconomically disadvantaged African-American and Hi spanic patients with recurrent or metastatic cancer and 2) to assess the al titudes of health care professionals who treat them. METHODS. In the first study 108 African-American and Hispanic patients with metastatic or recurrent cancer and pain completed a survey about their pai n intensity, pain interference, and attitudes toward analgesic medications. Physicians also rated their patients' pain and the adequacy of the patient s' current analgesic prescriptions was assessed. In the second study 55 phy sicians and nurses who treat these patients completed a questionnaire regar ding cancer pain and its management in their practice settings. RESULTS, Approximately 28% of the Hispanic and 31% of the African-American patients received analgesics of insufficient strength to manage their pain. Although the majority of patients received appropriate analgesics, 65% rep orted severe pain. Physicians underestimated pain severity for 64% of the H ispanic and 74% of the African-American patients. Physicians were more like ly to underestimate the pain severity of female patients than male patients . Inadequate pain assessment, patient reluctance to report pain, and lack o f staff time were perceived as barriers to pain management. CONCLUSIONS. Although the data suggest recent improvements in analgesic pre scribing practices for African-American and Hispanic cancer patients, the m ajority of patients reported high levels of pain and limited pain relief fr om analgesic medications. Inadequate pain assessment remains a major barrie r to optimal cancer pain treatment. Cancer 2000;88:1929-38. (C) 2000 Americ an Cancer Society.