Cancer pain management in Germany - Results and analysis of a questionnaire

The German regulations for opioid prescriptions have been changed in Februa ry 1998. The regulations have been made much more easier and should therefo re have improved the pain management in Germany. We investigated the knowle dge of the WHO analgesic ladder and how they have been followed in a nation -wide survey among physicians not specialised in pain management. Only 9% o f the questionnaires were returned. Although the majority of the physicians (93%) reported knowledge about the WHO recommendations for the treatment o f cancer pain, more than 15% of the participating physicians rated transder mal fentanyl as a weak opioid or even as a non-opioid. A negative pain mana gement index in 15% of the patients gave evidence of poor quality in pain m anagement. The majority of patients (84%) did not receive immediate release analgesics for the treatment of breakthrough pain. Continuous medical education is still necessary before a further alleviatio n of regulations will help to reduce the undertreatment of patients sufferi ng from cancer pain in Germany.