A survey of perceptions, attitudes, knowledge and practices of medical oncologists about cancer pain management in Spain

• Jesús García-Mata ^[4] ; Cecilio Álamo ^[1] ; Javier de Castro ^[5] ; Jorge Contreras ^[6] ; Rafael Gálvez ^[2] ; Carlos Jara ^[7] ; Antonio Llombart ^[8] ; Concepción Pérez ^[9] ; Pedro Sánchez ^[10] ; Susana Traseira ^[11] ; Juan-Jesús Cruz ^[3]
  1. [1] Universidad de Alcalá

     Universidad de Alcalá

     Alcalá de Henares, España

     
  2. [2] Hospital Universitario Virgen de las Nieves

     Hospital Universitario Virgen de las Nieves

     Granada, España

     
  3. [3] Hospital Universitario de Salamanca

     Hospital Universitario de Salamanca

     Salamanca, España

     
  4. [4] Santa María Nai Hospital, Orense
  5. [5] La Paz Hospital, Madrid
  6. [6] Carlos Haya Hospital, Málaga
  7. [7] Alcorcón Hospital
  8. [8] Arnau de Vilanova Hospital, Valencia
  9. [9] La Princesa Hospital, Madrid
  10. [10] Specialty Hospital Jaén
  11. [11] Mundipharma Pharmaceuticals, Madrid

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 20, Nº. 8, 2018, págs. 1061-1071
• Idioma: inglés
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• Resumen

  • Purpose To monitor oncologists’ perspective on cancer pain management.

    Methods An anonymized survey was conducted in two waves. First, over a convenience sample of oncologists known to be particularly concerned with the management of pain. Second, using a random sample of oncologists.

    Results In total, 73 and 82 oncologists participated in the first and second wave, respectively. Many oncologists reported to have good knowledge of analgesic drugs (95.9%), the mechanism of action of opioids (79.5%), and good skills to manage opioid-related bowel dysfunction (76.7%). Appropriate adjustment of background medication to manage breakthrough pain was reported by 95.5% of oncologists. Additionally, 87.7% (68.3% in the second wave, p = 0.035) of oncologists reported suitable opioid titration practices, and 90.4% reported to use co-adjuvant medications for neuropathic pain confidently. On the other hand, just 9.6% of oncologists participated in multidisciplinary pain management teams, and merely 30.3 and 27.1% reported to routinely collaborate with the Pain Clinics or involve other staff, respectively. Only 26.4% of the oncologists of the second wave gave priority to pain pathophysiology to decide therapies, and up to 75.6% reported difficulties in treating neuropathic pain. Significantly less oncologists of the second wave (82.9 vs. 94.5%, p = 0.001) used opioid rotation routinely.

    Conclusions Unlike in previous surveys, medical oncologists reported in general good knowledge and few perceived limitations and barriers for pain management. However, multi-disciplinary management and collaboration with other specialists are still uncommon. Oncologists’ commitment to optimize pain management seems important to improve and maintain good practices.