A survey of perceptions, attitudes, knowledge and practices of medical oncologists about cancer pain management in Spain
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To monitor oncologists’ perspective on cancer pain management.
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.
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.
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.
KeywordsClinical oncology Surveys and questionnaires Medical education Chronic pain Opioid analgesics Delivery of health care
The authors are grateful for the interest and time of the physicians who voluntarily contributed their opinions and data for this research. The authors also wish to thank Mar Serrano (Mundipharma, Madrid, Spain) and Jesús Villoria (Medicxact, S.L., Madrid, Spain) for preparing a draft of this manuscript, whose participation was funded by Mundipharma.
All authors participated in the review and extraction of literature, design of the study, interpretation of results and preparation of the manuscript. All authors had full access to the data and have provided their final approval of the version of the manuscript to be submitted for publication.
Compliance with ethical standards
Conflict of interest
Authors received funds from Mundipharma Pharmaceuticals, S.L. for this research. JG-M, JdC, JC, RG, CJ, AL, CP, PS and J-JC declare no competing interests to declare. CA has been a consultant or has received fees for pharmacological training or congressional participation in the last 3 years of Adamed, Exeltis, Grünenthal, Ferrer, GSK, Janssen Cilag, Juste SAQF, Kyowa Kirin Pharmaceutical, Lundbeck, Mundipharma Pharmaceutical, Normon, Otsuka Pharmaceutical, Pfizer, Rovi, Rubió, Servier and Shire. ST has a full-time job at Mundipharma Pharmaceuticals, S.L.
The manuscript does not contain clinical studies or patient data. According to Spanish regulations, neither approval from an Ethics Committee nor informed consent from patients were required, because all the data come from a survey of oncologists.
This research has received funds from Mundipharma Pharmaceuticals, S.L.
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