The Characteristics and the Pharmacological Management of Cancer Pain and Its Effect on the Patients' Daily Activities and their Quality of Life: A Cross - Sectional study from Malaysia.

CONTEXT: Pain is a major health care problem for the patients with cancer and one of the most frequent and disturbing cancer related symptoms. AIM: To study the characteristics of pain in cancer patients and its pharmacological management by using a subjective self-assessment questionnaire and the World Health Organization (WHO)analgesic ladder for pain management. SETTINGS AND DESIGNS: This study was conducted in the Oncology Wards of Penang Hospital, Penang, Malaysia. A questionnaire was developed to assess the pain characteristics and their effect on the patients' daily life activities and the information on the pharmacological management of the cancer pain. The cancer pain intensity was noted from the patients' medical database. METHOD AND MATERIAL: By using the validated questionnaire, an observational, cross sectional study was conducted on the cancer patientswho were admitted in the oncology wards of Penang Hospital, Malaysia, for a period of 1 month. STATISTICAL ANALYSIS: Descriptive statistics like mean, frequency and percentages were used for this study. RESULTS AND
CONCLUSION: A total of 42 patients out of 143, who fulfilled the criteria, were interviewed. The results showed mild pain in 66.7% (28) of the patients, moderate pain in 7.1% (3) and severe painin 26.2% (11). The normal daily life activities were affected by the pain in almost all the patients. Among the interviewed patients, sleep was affected in 88% (37) of the patients and the normal physical activity was affected in 92.9% (39) of the patients. Similarly, the pain decreased the appetite in 78.6% (33) of the patients, it affected the personal relationship in 35.7% (15), it affected the emotion in 71.5% (30) and it affected the visual activity in 33.6% (13) of the patients. Mild pain with distressing symptoms was not treated with any analgesic or adjuvant medications in 40.5% (17) of the patients. In contrast, all the patients with moderate and severe pain were treated with medications. Among them, 66.7% (2) of the patients with moderate pain and 90.9% (10) of the patients with severe pain were treated with analgesics as per the WHO analgesic ladder. The WHO analgesic ladder guide for pain management was followed in a majority of the cases, when analgesics were prescribed. However, there was inadequate treatment of the cancer pain in many patients with mild pain and, consequently, their quality of life was largely affected.