Berg, R. van der (Riemke) (2013) ‘De prevalentie van pijn bij kanker en de kwaliteit van de pijnbehandeling bij oncologische patiënten in het Medisch Centrum Leeuwarden’. thesis, Medicine.
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Abstract
Background: The incidence of cancer is rising because of an ageing population, increasing life expectancy and changes in lifestyle factors. Early detection of cancer and advances in anti-tumour treatment are the main causes of a rising prevalence rate of cancer. Pain is one of the five most common symptoms in cancer patients. In 1986, the WHO published the first guideline ‘Cancer pain relief’, which says it is possible to control pain in more than 90% of the patients. Nevertheless, literature shows that pain is undertreated. Methods: The purpose of this longitudinal, observational study was to describe the prevalence of pain, in particular the pain which was experienced by patients as a NRS score of at least 5, in cancer patients, who were seen on the outpatient department of internal medicine, in a peripheral hospital. To determine the quality of pain management, the Pain Management Index (PMI) was calculated. The PMI is a comparison of the strongest analgesic used by a patient, related to the level of experienced pain. This study would describe the change in pain management and in experienced pain over twelve weeks, in the patients with a NRS score of 5 or higher. Results: 114 out of the 210 patients (54,3%) who have filled in the questionnaire, said they had experienced pain or they had used analgesics, in the last week. The prevalence of pain and/or the use of analgesics seemed to be higher in patients who had distant metastases (p=0,02) and in patients for whom treatment was not feasible (p=0,01). 58 patients (50,9%) had a negative PMI, indicating inadequate pain management. Significantly more patients with no evidence of disease (p=0,001), patients who received curative treatment or who are seen in follow-up (p=0,001) and patients in whom the pain was related to the anti-tumour treatment (p=0,007), received inadequate pain treatment. 47 patients (41,2%) rated their pain, experienced in the previous week, with a NRS score of 5 or higher. 29 patients of the 47 patients (61,7%) were not treated adequately during the first measuring. The second questionnaire was returned by 35 patients, and 17 of them (48,6%) received no adequate pain treatment. The mean PMI seemed to be improved within three months (p=0,001). Only three patients (8,6%) denoted, in the second questionnaire, not to be satisfied with the level of attention paid to the pain by the physician. Conclusion: The prevalence of pain in cancer patients is high and according to the PMI, pain treatment is inadequately in patients who are receiving anti-tumour treatment and in patients who are seen in follow-up. The question is whether the PMI is the right measurement to determine the quality of pain treatment, actually it does not take into account how satisfied patients are with the pain treatment. More research is needed to describe the quality of pain management which takes into account patients’ reports of satisfaction with their pain treatment.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Fiets, dr. W.E. and Locatie: Oncologisch Centrum Leeuwarden (OCL), onderdeel va |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:45 |
| Last Modified: | 25 Jun 2020 10:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/645 |
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