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Supportive Care in Cancer

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01-01-2021 | Acupuncture | Original Article

Fear of analgesic side effects predicts preference for acupuncture: a cross-sectional study of cancer patients with pain in the USA

Authors: Kevin T. Liou, Kelly M. Trevino, Salimah H. Meghani, Q. Susan Li, Gary Deng, Deborah Korenstein, Jun J. Mao

Published in: Supportive Care in Cancer | Issue 1/2021

Abstract

Purpose

Approximately one in two cancer patients globally are under-treated for pain. Opioids and other analgesics represent the mainstay of cancer pain management; however, barriers to their use are well-documented. We evaluated whether acupuncture would be a preferable treatment option among cancer patients with attitudinal barriers to pharmacological pain management.

Methods

We conducted a cross-sectional survey of cancer patients at a tertiary urban cancer center and eleven suburban/rural hospitals in the Northeastern United States. We assessed attitudinal barriers to pharmacological pain management with the Barriers Questionnaire (BQ-13). The BQ-13 consists of two subscales: pain management beliefs and analgesic side effects. We also asked patients whether they prefer acupuncture, analgesics, or have no preference between these two modalities for pain management. Covariates included sociodemographics, clinical characteristics, and attitudes/beliefs about acupuncture. We used logistic regression to examine the association between attitudinal barriers and acupuncture preference.

Results

Among 628 patients, 197 (31.4%) preferred acupuncture for pain management, 146 (23.3%) preferred analgesics, and 285 (45.4%) had no preference. The highest reported attitudinal barriers were fear of addiction and fear of analgesic-associated constipation and nausea. Adjusting for covariates, we found that attitudinal barriers related to fear of analgesic side effects were significantly associated with acupuncture preference (adjusted odds ratio [AOR] 1.45, 95% confidence interval [CI] 1.17–1.81), but barriers related to pain management beliefs were not (AOR 1.17, 95% CI 0.91–1.51). Attitudes/beliefs about acupuncture (i.e., greater expected benefits, fewer perceived barriers, and more positive social norms) and female gender also predicted acupuncture preference, whereas race and educational status did not.

Conclusion

Acupuncture may be a preferable treatment option among cancer patients at risk of inadequately controlled pain due to fear of analgesic side effects. Evidence-based integration of acupuncture and analgesics, guided by patient treatment preferences, represents an essential aspect of patient-centered care and has potential to address unmet cancer pain management needs.

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Title: Fear of analgesic side effects predicts preference for acupuncture: a cross-sectional study of cancer patients with pain in the USA
Authors: Kevin T. Liou
Kelly M. Trevino
Salimah H. Meghani
Q. Susan Li
Gary Deng
Deborah Korenstein
Jun J. Mao
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Acupuncture
Opioids
Opioids
Analgesics in Dentistry
Anxiety
Published in: Supportive Care in Cancer / Issue 1/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05504-y

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