Sigridur Gunnarsdottir1,2, Valgerdur Sigurdardottir3, Marianne Kloke4, Lukas Radbruch5, Rainer Sabatowski6, Stein Kaasa7,8, Pål Klepstad7,9,10. 1. Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. sigridgu@landspitali.is. 2. Faculty of Nursing, Landspitali-The University Hospital of Iceland, University of Iceland, Eiriksgata 5, 101, Reykjavik, Iceland. sigridgu@landspitali.is. 3. Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 4. Kliniken Essen-Mitte Germany, Essen, Germany. 5. Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany. 6. Comprehensive Pain Center, University Hospital "Carl Gustav Carus," Technical University Dresden, Dresden, Germany. 7. European Palliative Care Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. 8. Oslo University Hospital and University of Oslo, Oslo, Norway. 9. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. 10. Department of Anesthesiology and Intensive Care Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Abstract
PURPOSE: The purpose of this study was to examine attitudinal barriers to cancer pain management and their relationship to pain, analgesic use, clinical, and demographic variables, as well as QOL, in a large sample of patients receiving strong opioids for pain in three European countries. METHODS: Participants in the present study were 555 patients with cancer, 18 years and older recruited from six centers in Germany, Iceland, and Norway. All had received strong opioids for at least 72 h. Data was collected with the Barriers Questionnaire-II, the Brief Pain Inventory, and the European Organization for Research and Treatment of Cancer QLQ-C30. RESULTS: The mean (SD) age of patients was 61.68 (12.35) years and 53% were men. Most common diagnoses were gastrointestinal, lung, prostate, and breast cancer. The mean (SD) time from diagnosis was 32.24 (44.55) and 4.97 (9.64) months from start of opioid therapy. Mean (SD) pain severity was 3.19 (1.93) on a 0 to 10 scale, and 46.5% reported worst pain of 7 or higher. Attitudinal barriers had a mean (SD) of 1.95 (0.82) on a 0-5 scale, with fear of addiction as the strongest barrier across countries 2.85 (1.49). Barrier scores increased with age, and were higher among men than women. Higher barrier scores were associated with higher pain severity and interference, and lower performance status, but not with global health-QOL. Patients who had been on opioids for a shorter time reported higher barriers. CONCLUSIONS: Attitudinal barriers are frequent in cancer pain patients on opioids and are associated with less effective pain control.
PURPOSE: The purpose of this study was to examine attitudinal barriers to cancer pain management and their relationship to pain, analgesic use, clinical, and demographic variables, as well as QOL, in a large sample of patients receiving strong opioids for pain in three European countries. METHODS:Participants in the present study were 555 patients with cancer, 18 years and older recruited from six centers in Germany, Iceland, and Norway. All had received strong opioids for at least 72 h. Data was collected with the Barriers Questionnaire-II, the Brief Pain Inventory, and the European Organization for Research and Treatment of Cancer QLQ-C30. RESULTS: The mean (SD) age of patients was 61.68 (12.35) years and 53% were men. Most common diagnoses were gastrointestinal, lung, prostate, and breast cancer. The mean (SD) time from diagnosis was 32.24 (44.55) and 4.97 (9.64) months from start of opioid therapy. Mean (SD) pain severity was 3.19 (1.93) on a 0 to 10 scale, and 46.5% reported worst pain of 7 or higher. Attitudinal barriers had a mean (SD) of 1.95 (0.82) on a 0-5 scale, with fear of addiction as the strongest barrier across countries 2.85 (1.49). Barrier scores increased with age, and were higher among men than women. Higher barrier scores were associated with higher pain severity and interference, and lower performance status, but not with global health-QOL. Patients who had been on opioids for a shorter time reported higher barriers. CONCLUSIONS: Attitudinal barriers are frequent in cancer painpatients on opioids and are associated with less effective pain control.
Authors: M H J van den Beuken-van Everdingen; J M de Rijke; A G Kessels; H C Schouten; M van Kleef; J Patijn Journal: Ann Oncol Date: 2007-03-12 Impact factor: 32.976
Authors: Pål Klepstad; Jon Håvard Loge; Petter C Borchgrevink; Tito R Mendoza; Charles S Cleeland; Stein Kaasa Journal: J Pain Symptom Manage Date: 2002-11 Impact factor: 3.612
Authors: Kathryn A Martinez; Rebecca A Aslakson; Renee F Wilson; Colleen C Apostol; Oluwakemi A Fawole; Brandyn D Lau; Daniela Vollenweider; Eric B Bass; Sydney M Dy Journal: Am J Hosp Palliat Care Date: 2013-02-12 Impact factor: 2.500
Authors: Wendy H Oldenmenger; Peter A E Sillevis Smitt; Silvia van Dooren; Gerrit Stoter; Carin C D van der Rijt Journal: Eur J Cancer Date: 2009-02-07 Impact factor: 9.162
Authors: Morten Thronæs; Trude Rakel Balstad; Cinzia Brunelli; Erik Torbjørn Løhre; Pål Klepstad; Ola Magne Vagnildhaug; Stein Kaasa; Anne Kari Knudsen; Tora Skeidsvoll Solheim Journal: Support Care Cancer Date: 2019-07-09 Impact factor: 3.603
Authors: Kevin T Liou; Kelly M Trevino; Salimah H Meghani; Q Susan Li; Gary Deng; Deborah Korenstein; Jun J Mao Journal: Support Care Cancer Date: 2020-05-08 Impact factor: 3.603
Authors: Rafa Rahman; Sara Wallam; Bo Zhang; Rahul Sachdev; Emmanuel L McNeely; Khaled M Kebaish; Lee H Riley; David B Cohen; Amit Jain; Sang H Lee; Daniel M Sciubba; Richard L Skolasky; Brian J Neuman Journal: World Neurosurg Date: 2021-03-19 Impact factor: 2.210
Authors: Pete Wegier; Jaymie Varenbut; Mark Bernstein; Peter G Lawlor; Sarina R Isenberg Journal: BMC Palliat Care Date: 2020-11-29 Impact factor: 3.234
Authors: Abdulaziz Alodhayani; Khalid M Almutairi; Jason M Vinluan; Norah Alsadhan; Turky H Almigbal; Wadi B Alonazi; Mohammed Ali Batais Journal: Front Psychol Date: 2021-08-26