Papers

Multicentre study of cancer pain and its treatment in France

Pain Consultation, Hopital International Universite de Paris, 75674 Paris, France F Larue, pain consultant. Pain Research Group and WHO Collaborating Centre for Symptom Evaluation in Cancer Care, University of Wisconsin Medical School, Madison, WI 53705, USA C S Cleeland, director S M Colleau, assistant director for communication. Pain Consultation, Hopital Ambroise Pare, 92104 Boulogne, France L Brasseur, pain consultant. Correspondence to: Dr Larue.

Abstract

Objective: To describe the treatment of cancer pain in France and to evaluate the predictive factors for inadequate management.
Design: Multicentre, representative cross sectional survey.
Setting: 20 treatment centres, including cancer centres, university hospitals, state hospitals, private clinics, and one homecare setting (in which patients are supported at home).
Subjects: 605 patients with cancer.
Main measures: Patients rated prevalence and severity of pain and functional impairment related to pain. Doctors reported patients' cancer characteristic, performance status, pain severity, and analgesic drugs ordered.
Results: 57% (340/601) of patients with cancer reported pain due to their disease, and, of those with pain, 69% (224/325) rated their worst pain at a level that impaired their ability to function. 30% (84/279) were reported as receiving no drugs for their pain. Of the 270 patients in pain for whom information on treatment was available 51% (137/270) were not receiving adequate pain relief, according to an index based on the World Health Organisation's guidelines. French doctors were found to underestimate the severity of their patients' pain. Younger patients, patients without metastatic disease, patients with a better performance status, and patients who rated their pain as more severe than their doctors did were at greater risk for undertreatment of their pain.
Conclusions: In the light of the high prevalence and the severity of pain among patients with cancer, the assessment and treatment of cancer pain in France remain inadequate, emphasising the need for changes in patient care.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Control of pain in adults with cancer: summary of SIGN guidelines

P J Cormie, M Nairn, J Welsh on behalf of the Guideline Development Group
BMJ 2008 337: a2154. [Extract] [Full Text]

Treatment for cancer pain in France

M Zenz and T Zenz
BMJ 1995 311: 387. [Extract] [Full Text]

This article has been cited by other articles:

• Gagliese, L. (2009). Aging and the management of cancer pain. Ann Oncol 20: 1752-1752 [Full text]  
• Breivik, H., Cherny, N., Collett, B., de Conno, F., Filbet, M., Foubert, A. J., Cohen, R., Dow, L. (2009). Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 20: 1420-1433 [Abstract] [Full text]  
• Golan, E., Haggiag, I., Os, P., Bernheim, J. (2009). Calcium, Parathyroid Hormone, and Vitamin D: Major Determinants of Chronic Pain in Hemodialysis Patients. CJASN 4: 1374-1380 [Abstract] [Full text]  
• Cormie, P J, Nairn, M, Welsh, J, on behalf of the Guideline Development Group, (2008). Control of pain in adults with cancer: summary of SIGN guidelines. BMJ 337: a2154-a2154 [Full text]  
• van den Beuken-van Everdingen, M., de Rijke, J., Kessels, A., Schouten, H., van Kleef, M, Patijn, J (2007). Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18: 1437-1449 [Abstract] [Full text]  
• Brennan, F., Carr, D. B., Cousins, M. (2007). Pain Management: A Fundamental Human Right. Anesth. Analg. 105: 205-221 [Abstract] [Full text]  
• Holtan, A., Aass, N., Nordoy, T., Haugen, D. F., Kaasa, S., Mohr, W., Kongsgaard, U. E (2007). Prevalence of pain in hospitalised cancer patients in Norway: a national survey. Palliat Med 21: 7-13 [Abstract]  
• Yun, Y. H., Park, S. M., Lee, K., Chang, Y. J., Heo, D. S., Kim, S.-Y., Hong, Y. S., Huh, B. Y. (2005). Predictors of prescription of morphine for severe cancer pain by physicians in Korea. Ann Oncol 16: 966-971 [Abstract] [Full text]  
• McGuire, D. B. (2004). Occurrence of Cancer Pain. J Natl Cancer Inst Monogr 2004: 51-56 [Abstract] [Full text]  
• Durieux, P, Bissery, A, Dubois, S, Gasquet, I, Coste, J (2004). Comparison of health care professionals' self-assessments of standards of care and patients' opinions on the care they received in hospital: observational study. Qual Saf Health Care 13: 198-202 [Abstract] [Full text]  
• Okuyama, T., Wang, X. S., Akechi, T., Mendoza, T. R., Hosaka, T., Cleeland, C. S., Uchitomi, Y. (2004). Adequacy of Cancer Pain Management in a Japanese Cancer Hospital. Jpn J Clin Oncol 34: 37-42 [Abstract] [Full text]  
• Schiffmann, R., Kopp, J. B., Austin III, H. A., Sabnis, S., Moore, D. F., Weibel, T., Balow, J. E., Brady, R. O. (2001). Enzyme Replacement Therapy in Fabry Disease: A Randomized Controlled Trial. JAMA 285: 2743-2749 [Abstract] [Full text]  
• Morrison, R. S., Wallenstein, S., Natale, D. K., Senzel, R. S., Huang, L.-L. (2000). "We Don't Carry That" -- Failure of Pharmacies in Predominantly Nonwhite Neighborhoods to Stock Opioid Analgesics. NEJM 342: 1023-1026 [Abstract] [Full text]  
• Grande, G E, Todd, C J (2000). Why are trials in palliative care so difficult?. Palliat Med 14: 69-74  
• Larue, F., Fontaine, A., Brasseur, L. (1999). Evolution of the French Public's Knowledge and Attitudes Regarding Postoperative Pain, Cancer Pain, and Their Treatments: Two National Surveys over a Six-Year Period. Anesth. Analg. 89: 659-659 [Abstract] [Full text]  
• de Wit, R., van Dam, F., Abu-Saad, H. H., Loonstra, S., Zandbelt, L., van Buuren, A., van der Heijden, K., Leenhouts, G. (1999). Empirical Comparison of Commonly Used Measures to Evaluate Pain Treatment in Cancer Patients With Chronic Pain. JCO 17: 1280-1280 [Abstract] [Full text]  
• Morize, V., Nguyen, D. T., Lorente, C., Desfosses, G. (1999). Descriptive epidemiological survey on a given day in all palliative care patients hospitalized in a French university hospital. Palliat Med 13: 105-117 [Abstract]  
• Cleeland, C. S. (1998). Undertreatment of Cancer Pain in Elderly Patients. JAMA 279: 1914-1915 [Full text]  
• Martin, A. J., Stockler, M. (1998). Quality-of-Life Assessment in Health Care Research and Practice. Eval Health Prof 21: 141-156 [Abstract]  
• Grande, G., Barclay, S., Todd, C. (1997). Difficulty of symptom control and general practitioners' knowledge of patients' symptoms. Palliat Med 11: 399-406 [Abstract]  
• Larue, F., Fontaine, A., Colleau, S. M (1997). Underestimation and undertreatment of pain in HIV disease: multicentre study. BMJ 314: 23-23 [Abstract] [Full text]  
• Ahmedzai, S, Brooks, D J (1995). Treatment for cancer pain. BMJ 311: 951b-951 [Full text]  
• Zenz, M, Zenz, T (1995). Treatment for cancer pain in France. BMJ 311: 387-387 [Full text]