Impact of Undertreatment of Cancer Pain With Analgesic Drugs on Patient Outcomes

A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan

Wen Chi Shen, Jen Shi Chen, Yu Yun Shao, Kuan Der Lee, Tzeon Jye Chiou, Yung Chuan Sung, Kun Ming Rau, Chia Jui Yen, Yu Min Liao, Ta Chih Liu, Ming Fang Wu, Ming Yang Lee, Ming Sun Yu, Wen Li Hwang, Pang Yu Lai, Cheng Shyong Chang, Wen Chi Chou, Ruey Kuen Hsieh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Context Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). Objectives This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. Methods A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey. All patients completed a questionnaire based on the Brief Pain Inventory. Pain management index (PMI) was used to evaluate the adequacy of pain management. Possible clinical variables of patients with positive PMI were examined by univariate and multivariate logistic regressions. Results A total of 1659 (62.6%) outpatients had experienced some degree of pain; among these, 32.4% had negative PMI. Patients with a negative PMI score had significantly poor outcomes of QoL and a significantly higher tendency toward dissatisfaction with pain control by the physician and with the prescribed analgesic drugs. Female gender, primary tumor from breast, non–cancer-related cause of pain, and hospital locations from north Taiwan were independent variables that predicated patients with undertreatment of cancer pain. Most importantly, a forward trend of undertreatment of pain among patients who presented with lower prevalent rate of pain was observed. Conclusion One-third of Taiwanese outpatients experienced pain because of undertreatment. Awareness of the prevalence of undertreatment of cancer pain and identification of the vulnerable subjects may assist in enhancing patient care and improving patient's QoL.

Original languageEnglish
Pages (from-to)55-65.e1
JournalJournal of Pain and Symptom Management
Volume54
Issue number1
DOIs
Publication statusPublished - Jul 1 2017

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Taiwan
Analgesics
Patient Care
Outpatients
Pain Management
Pain
Neoplasms
Quality of Life
Cancer Pain
Surveys and Questionnaires
Logistic Models
Breast Neoplasms
Physicians
Equipment and Supplies

Keywords

  • cancer
  • Pain
  • pain management index
  • pain survey
  • quality of life

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Impact of Undertreatment of Cancer Pain With Analgesic Drugs on Patient Outcomes : A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan. / Shen, Wen Chi; Chen, Jen Shi; Shao, Yu Yun; Lee, Kuan Der; Chiou, Tzeon Jye; Sung, Yung Chuan; Rau, Kun Ming; Yen, Chia Jui; Liao, Yu Min; Liu, Ta Chih; Wu, Ming Fang; Lee, Ming Yang; Yu, Ming Sun; Hwang, Wen Li; Lai, Pang Yu; Chang, Cheng Shyong; Chou, Wen Chi; Hsieh, Ruey Kuen.

In: Journal of Pain and Symptom Management, Vol. 54, No. 1, 01.07.2017, p. 55-65.e1.

Research output: Contribution to journalArticle

Shen, WC, Chen, JS, Shao, YY, Lee, KD, Chiou, TJ, Sung, YC, Rau, KM, Yen, CJ, Liao, YM, Liu, TC, Wu, MF, Lee, MY, Yu, MS, Hwang, WL, Lai, PY, Chang, CS, Chou, WC & Hsieh, RK 2017, 'Impact of Undertreatment of Cancer Pain With Analgesic Drugs on Patient Outcomes: A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan', Journal of Pain and Symptom Management, vol. 54, no. 1, pp. 55-65.e1. https://doi.org/10.1016/j.jpainsymman.2017.02.018
Shen, Wen Chi ; Chen, Jen Shi ; Shao, Yu Yun ; Lee, Kuan Der ; Chiou, Tzeon Jye ; Sung, Yung Chuan ; Rau, Kun Ming ; Yen, Chia Jui ; Liao, Yu Min ; Liu, Ta Chih ; Wu, Ming Fang ; Lee, Ming Yang ; Yu, Ming Sun ; Hwang, Wen Li ; Lai, Pang Yu ; Chang, Cheng Shyong ; Chou, Wen Chi ; Hsieh, Ruey Kuen. / Impact of Undertreatment of Cancer Pain With Analgesic Drugs on Patient Outcomes : A Nationwide Survey of Outpatient Cancer Patient Care in Taiwan. In: Journal of Pain and Symptom Management. 2017 ; Vol. 54, No. 1. pp. 55-65.e1.
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abstract = "Context Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). Objectives This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. Methods A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey. All patients completed a questionnaire based on the Brief Pain Inventory. Pain management index (PMI) was used to evaluate the adequacy of pain management. Possible clinical variables of patients with positive PMI were examined by univariate and multivariate logistic regressions. Results A total of 1659 (62.6{\%}) outpatients had experienced some degree of pain; among these, 32.4{\%} had negative PMI. Patients with a negative PMI score had significantly poor outcomes of QoL and a significantly higher tendency toward dissatisfaction with pain control by the physician and with the prescribed analgesic drugs. Female gender, primary tumor from breast, non–cancer-related cause of pain, and hospital locations from north Taiwan were independent variables that predicated patients with undertreatment of cancer pain. Most importantly, a forward trend of undertreatment of pain among patients who presented with lower prevalent rate of pain was observed. Conclusion One-third of Taiwanese outpatients experienced pain because of undertreatment. Awareness of the prevalence of undertreatment of cancer pain and identification of the vulnerable subjects may assist in enhancing patient care and improving patient's QoL.",
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AU - Lee, Kuan Der

AU - Chiou, Tzeon Jye

AU - Sung, Yung Chuan

AU - Rau, Kun Ming

AU - Yen, Chia Jui

AU - Liao, Yu Min

AU - Liu, Ta Chih

AU - Wu, Ming Fang

AU - Lee, Ming Yang

AU - Yu, Ming Sun

AU - Hwang, Wen Li

AU - Lai, Pang Yu

AU - Chang, Cheng Shyong

AU - Chou, Wen Chi

AU - Hsieh, Ruey Kuen

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N2 - Context Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). Objectives This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. Methods A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey. All patients completed a questionnaire based on the Brief Pain Inventory. Pain management index (PMI) was used to evaluate the adequacy of pain management. Possible clinical variables of patients with positive PMI were examined by univariate and multivariate logistic regressions. Results A total of 1659 (62.6%) outpatients had experienced some degree of pain; among these, 32.4% had negative PMI. Patients with a negative PMI score had significantly poor outcomes of QoL and a significantly higher tendency toward dissatisfaction with pain control by the physician and with the prescribed analgesic drugs. Female gender, primary tumor from breast, non–cancer-related cause of pain, and hospital locations from north Taiwan were independent variables that predicated patients with undertreatment of cancer pain. Most importantly, a forward trend of undertreatment of pain among patients who presented with lower prevalent rate of pain was observed. Conclusion One-third of Taiwanese outpatients experienced pain because of undertreatment. Awareness of the prevalence of undertreatment of cancer pain and identification of the vulnerable subjects may assist in enhancing patient care and improving patient's QoL.

AB - Context Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). Objectives This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. Methods A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey. All patients completed a questionnaire based on the Brief Pain Inventory. Pain management index (PMI) was used to evaluate the adequacy of pain management. Possible clinical variables of patients with positive PMI were examined by univariate and multivariate logistic regressions. Results A total of 1659 (62.6%) outpatients had experienced some degree of pain; among these, 32.4% had negative PMI. Patients with a negative PMI score had significantly poor outcomes of QoL and a significantly higher tendency toward dissatisfaction with pain control by the physician and with the prescribed analgesic drugs. Female gender, primary tumor from breast, non–cancer-related cause of pain, and hospital locations from north Taiwan were independent variables that predicated patients with undertreatment of cancer pain. Most importantly, a forward trend of undertreatment of pain among patients who presented with lower prevalent rate of pain was observed. Conclusion One-third of Taiwanese outpatients experienced pain because of undertreatment. Awareness of the prevalence of undertreatment of cancer pain and identification of the vulnerable subjects may assist in enhancing patient care and improving patient's QoL.

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KW - Pain

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KW - quality of life

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