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Published in: Supportive Care in Cancer 11/2012

01-11-2012 | Original Article

Physicians’ self-assessment of cancer pain treatment skills—more training required

Authors: M. Silvoniemi, T. Vasankari, T. Vahlberg, E. Vuorinen, K. E. Clemens, E. Salminen

Published in: Supportive Care in Cancer | Issue 11/2012

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Abstract

Purpose

Adequate pain control is essential in cancer treatment. We surveyed Finnish physicians’ perception on their skills and training needs on palliative pain management.

Methods

A structured questionnaire with multiple choices and open ended questions was used for collecting data in 2006–2008. Of 720 physicians participating, 59 were working in oncology and 661 physicians in internal medicine, geriatrics, and primary health care.

Results

The principles of the WHO guidelines of cancer pain management were not well known. Forty-six percent of oncologists and 32% of other physicians (P < 0.0001) knew the analgesic ladder consisting of three steps. Forty-seven percent of oncologists and 61% of other physicians considered pain treatment of cancer patients being well managed in Finland. Only 24% of oncologists and 5% of other physicians considered the education in palliative care being currently at a satisfactory level. Oncologists reported a need of training in interaction and communication skills, ethical questions, and palliative home care. The other physicians expressed the strongest need for training in pain management and palliative care.

Conclusions

To have more confidence in treating cancer, pain physicians would benefit in training and education in palliative care. It should be systematically included both in general and specialist training and continuous medical education.
Literature
1.
go back to reference van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18:1437–1449PubMedCrossRef van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18:1437–1449PubMedCrossRef
2.
go back to reference Costantini M, Ripamonti C, Beccaro M, Montella M, Borgia P, Casella C et al (2009) Prevalence, distress, management and relief of pain during the last three months of cancer patients’ life. Results of an Italian mortality follow-back survey. Ann Oncol 20:729–735PubMedCrossRef Costantini M, Ripamonti C, Beccaro M, Montella M, Borgia P, Casella C et al (2009) Prevalence, distress, management and relief of pain during the last three months of cancer patients’ life. Results of an Italian mortality follow-back survey. Ann Oncol 20:729–735PubMedCrossRef
3.
go back to reference World Health Organization (1986) Cancer pain relief. WHO Publications Center, Albany World Health Organization (1986) Cancer pain relief. WHO Publications Center, Albany
4.
go back to reference World Health Organization (1996) Cancer pain relief: with a guide to opioids availability-2nd edition. WHO Office Publication, Geneva World Health Organization (1996) Cancer pain relief: with a guide to opioids availability-2nd edition. WHO Office Publication, Geneva
5.
go back to reference Zech DF, Grond S, Lynch J, Hertel D, Lehmann KA (1995) Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study. Pain 63:65–76PubMedCrossRef Zech DF, Grond S, Lynch J, Hertel D, Lehmann KA (1995) Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study. Pain 63:65–76PubMedCrossRef
6.
go back to reference Ventafridda V, Tamburini M, Caraceni A, De Conno F, Naldi F (1987) A validation study of the method for cancer pain relief. Cancer 59:850–856PubMedCrossRef Ventafridda V, Tamburini M, Caraceni A, De Conno F, Naldi F (1987) A validation study of the method for cancer pain relief. Cancer 59:850–856PubMedCrossRef
7.
go back to reference Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ et al (2009) Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 20:1420–1433PubMedCrossRef Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ et al (2009) Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 20:1420–1433PubMedCrossRef
8.
go back to reference Gallagher R, Hawley P, Yeomans W (2004) A survey of cancer pain management knowledge and attitudes of British Columbian physicians. Pain Res Manag Winter 9(4):188–94 Gallagher R, Hawley P, Yeomans W (2004) A survey of cancer pain management knowledge and attitudes of British Columbian physicians. Pain Res Manag Winter 9(4):188–94
9.
go back to reference Okuyama T, Wang XS, Akechi T, Mendoza TR, Hosaka T, Cleeland CS et al (2004) Adequacy of cancer pain management in a Japanese Cancer Hospital. Jpn J Clin Oncol 34(1):37–42PubMedCrossRef Okuyama T, Wang XS, Akechi T, Mendoza TR, Hosaka T, Cleeland CS et al (2004) Adequacy of cancer pain management in a Japanese Cancer Hospital. Jpn J Clin Oncol 34(1):37–42PubMedCrossRef
10.
go back to reference Pflughaupt M, Scharnagel R, Gossrau G, Kaiser U, Koch T, Sabatowski R (2010) Physicians’ knowledge and attitudes concerning the use of opioids in the treatment of chronic cancer and non-cancer pain. Schmerz 24:267–75PubMedCrossRef Pflughaupt M, Scharnagel R, Gossrau G, Kaiser U, Koch T, Sabatowski R (2010) Physicians’ knowledge and attitudes concerning the use of opioids in the treatment of chronic cancer and non-cancer pain. Schmerz 24:267–75PubMedCrossRef
11.
go back to reference Kaasalainen V, Vainio A, Ali-Melkkilä T (1997) Developments in the treatment of cancer pain in Finland: the third nation-wide survey. Pain 70:175–183PubMedCrossRef Kaasalainen V, Vainio A, Ali-Melkkilä T (1997) Developments in the treatment of cancer pain in Finland: the third nation-wide survey. Pain 70:175–183PubMedCrossRef
12.
go back to reference Silvoniemi M, Vasankari T, Vahlberg T, Clemens KE, Salminen E (2010) Physicians' attitudes towards euthanasia in Finland: would training in palliative care make a difference? Palliat Med 24:744–745PubMedCrossRef Silvoniemi M, Vasankari T, Vahlberg T, Clemens KE, Salminen E (2010) Physicians' attitudes towards euthanasia in Finland: would training in palliative care make a difference? Palliat Med 24:744–745PubMedCrossRef
13.
go back to reference Clemens KE, Klein E, Jaspers B, Klaschik E (2008) Attitudes toward active euthanasia among medical students at two German universities. Support Care Cancer 16:539–545PubMedCrossRef Clemens KE, Klein E, Jaspers B, Klaschik E (2008) Attitudes toward active euthanasia among medical students at two German universities. Support Care Cancer 16:539–545PubMedCrossRef
14.
go back to reference Clemens KE, Jaspers B, Klein E, Klaschik E (2008) Tuition in palliative medicine. Does it have an impact on future physicians' attitudes toward active euthanasia? Schmerz 22:458–464PubMedCrossRef Clemens KE, Jaspers B, Klein E, Klaschik E (2008) Tuition in palliative medicine. Does it have an impact on future physicians' attitudes toward active euthanasia? Schmerz 22:458–464PubMedCrossRef
15.
go back to reference Kellerman SE, Herold J (2001) Physician response to surveys. a review of the literature. Am J Prev Med 20(1):61–67PubMedCrossRef Kellerman SE, Herold J (2001) Physician response to surveys. a review of the literature. Am J Prev Med 20(1):61–67PubMedCrossRef
16.
go back to reference Ripamonti CI, Bandieri E, Roila F (2011) Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol 22(6):vi69–vi77PubMedCrossRef Ripamonti CI, Bandieri E, Roila F (2011) Management of cancer pain: ESMO clinical practice guidelines. Ann Oncol 22(6):vi69–vi77PubMedCrossRef
17.
go back to reference Wolfert MZ, Gilson AM, Dahl JL, Cleary JF (2010) Opioid analgesics for pain control: Wisconsin physicians’ knowledge, beliefs, attitudes, and prescribing practices. Pain Med 11:425–434PubMedCrossRef Wolfert MZ, Gilson AM, Dahl JL, Cleary JF (2010) Opioid analgesics for pain control: Wisconsin physicians’ knowledge, beliefs, attitudes, and prescribing practices. Pain Med 11:425–434PubMedCrossRef
18.
go back to reference Warncke T, Breivik H, Vainio A (1994) Treatment of cancer pain in Norway. A questionnaire study. Pain 57:109–116PubMedCrossRef Warncke T, Breivik H, Vainio A (1994) Treatment of cancer pain in Norway. A questionnaire study. Pain 57:109–116PubMedCrossRef
19.
go back to reference Maltoni M, Scarpi E, Modonesi C, Passardi A, Calpona S, Turriziani A et al (2005) A validation study of the WHO analgesic ladder: a two-step vs three-step strategy. Support Care Cancer 13:888–894PubMedCrossRef Maltoni M, Scarpi E, Modonesi C, Passardi A, Calpona S, Turriziani A et al (2005) A validation study of the WHO analgesic ladder: a two-step vs three-step strategy. Support Care Cancer 13:888–894PubMedCrossRef
20.
go back to reference Breuer B, Cruciani R, Portenoy RK (2010) Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey. South Med J 103:738–747PubMedCrossRef Breuer B, Cruciani R, Portenoy RK (2010) Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey. South Med J 103:738–747PubMedCrossRef
21.
go back to reference Davis MP, Walsh D (2004) Epidemiology of cancer pain and factors influencing poor pain control. Am J Hosp Palliat Care 21:137–42PubMedCrossRef Davis MP, Walsh D (2004) Epidemiology of cancer pain and factors influencing poor pain control. Am J Hosp Palliat Care 21:137–42PubMedCrossRef
22.
go back to reference Deandrea S, Montanari M, Moja L, Apolone G (2008) Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol 19:1985–1991PubMedCrossRef Deandrea S, Montanari M, Moja L, Apolone G (2008) Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol 19:1985–1991PubMedCrossRef
23.
go back to reference Peker L, Celebi N, Canbay O, Sahin A, Cakir B, Uzun S et al (2008) Doctors’ opinions, knowledge and attitudes towards cancer pain management in a university hospital. Agri 20:20–30PubMed Peker L, Celebi N, Canbay O, Sahin A, Cakir B, Uzun S et al (2008) Doctors’ opinions, knowledge and attitudes towards cancer pain management in a university hospital. Agri 20:20–30PubMed
24.
go back to reference Bailey FA, Burgio KL, Woodby LL, Williams BR, Redden DT, Kovac SH et al (2005) Improving processes of hospital care during the last hours of life. Arch Intern Med 165:1722–1727PubMedCrossRef Bailey FA, Burgio KL, Woodby LL, Williams BR, Redden DT, Kovac SH et al (2005) Improving processes of hospital care during the last hours of life. Arch Intern Med 165:1722–1727PubMedCrossRef
25.
go back to reference Latvala A, Syrjänen K, Salmenoja H, Salminen E (2009) Anaemia and other predictors of fatigue among patients on palliative therapy for advanced cancer. Anticancer Res 29(7):2569–75PubMed Latvala A, Syrjänen K, Salmenoja H, Salminen E (2009) Anaemia and other predictors of fatigue among patients on palliative therapy for advanced cancer. Anticancer Res 29(7):2569–75PubMed
26.
go back to reference Charlton R, Currie A (2008) A UK perspective on worldwide inadequacies in palliative care training: a short postgraduate course is proposed. Am J Hosp Palliat Care 25:63–71PubMedCrossRef Charlton R, Currie A (2008) A UK perspective on worldwide inadequacies in palliative care training: a short postgraduate course is proposed. Am J Hosp Palliat Care 25:63–71PubMedCrossRef
27.
go back to reference MacDonald N, Ayoub J, Farley J, Foucault C, Lesage P, Mayo N (2002) A Quebec survey of issues in cancer pain management. J Pain Symptom Manage 23:39–47PubMedCrossRef MacDonald N, Ayoub J, Farley J, Foucault C, Lesage P, Mayo N (2002) A Quebec survey of issues in cancer pain management. J Pain Symptom Manage 23:39–47PubMedCrossRef
28.
go back to reference Rurup ML, Rhodius CA, Borgsteede SD, Boddaert MS, Keijser AG, Pasman HR et al (2010) The use of opioids at the end of life: the knowledge level of Dutch physicians as a potential barrier to effective pain management. BMC Palliative Care 9:23PubMedCrossRef Rurup ML, Rhodius CA, Borgsteede SD, Boddaert MS, Keijser AG, Pasman HR et al (2010) The use of opioids at the end of life: the knowledge level of Dutch physicians as a potential barrier to effective pain management. BMC Palliative Care 9:23PubMedCrossRef
29.
go back to reference Cherny NI, Catane R (2003) Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer. Report on a survey by the European Society of Medical Oncology taskforce on palliative and supportive care. Cancer 98:2502–10PubMedCrossRef Cherny NI, Catane R (2003) Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer. Report on a survey by the European Society of Medical Oncology taskforce on palliative and supportive care. Cancer 98:2502–10PubMedCrossRef
Metadata
Title
Physicians’ self-assessment of cancer pain treatment skills—more training required
Authors
M. Silvoniemi
T. Vasankari
T. Vahlberg
E. Vuorinen
K. E. Clemens
E. Salminen
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 11/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1396-9

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