Cancer Res Treat.  2014 Apr;46(2):131-140.

A Nationwide Survey of Knowledge of and Compliance with Cancer Pain Management Guidelines by Korean Physicians

• Kim DY
• Ahn JS
• Lee KH
• Kim YC
• Lee J
• Kim SY

Abstract

PURPOSE
Although cancer pain is prevalent, under-treatment still remains a problem. Knowledge of and compliance with guidelines for management of cancer pain were analyzed for exploration of physician-related barriers to cancer pain management. In addition, physicians' knowledge and its correlation with cancer pain control were audited.
MATERIALS AND METHODS
From July 8 to December 2, 2010, a nationwide survey of house staff enquired about their knowledge of cancer pain control guidelines, and the medical records of patients under their care were analyzed.
RESULTS
In total, 180 physicians participated in the study. Their average score for knowledge was 14.6 (range, 7 to 19; maximum possible, 20). When the knowledge score was divided into low, medium, and high scores, patients receiving care from physicians with high levels of knowledge tended to have better cancer pain control (p<0.001). Of the total patients with severe pain, 19.5% were not prescribed strong opioids, and 40% were not prescribed any medication for breakthrough pain.
CONCLUSION
Physicians' knowledge of guidelines for control of cancer pain showed an association with improvement of pain management. Overall adherence to the guidelines was lacking. Continuous interventions such as education and audits regarding cancer pain control guidelines for physician are needed.

Keyword

Pain; Neoplasms; Knowledge; Analgesics; Guideline; Compliance

MeSH Terms

Analgesics
Analgesics, Opioid
Breakthrough Pain
Compliance*
Education
Humans
Internship and Residency
Medical Records
Pain Management*
Analgesics
Analgesics, Opioid

Figure

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  Fig. 1 Distribution of physicians' scores for knowledge of cancer pain guidelines.

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  Fig. 2 Correlation between changes of numeric rating scale (NRS) level and level of physician knowledge (p<0.0001).

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  Fig. 3 Correlation between pain severity and level of physician knowledge (missing data, n=338) (p<0.0001).

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