522O_PR - Analgesia for cancer pain in Southeast Asia (SEA): Prescription patterns, pain control, treatment satisfaction and quality of life (QoL)

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Supportive and palliative care
Topics Supportive Measures
Psychosocial Aspects of Cancer
Presenter Francis Javier
Citation Annals of Oncology (2016) 27 (suppl_9): ix170-ix176. 10.1093/annonc/mdw599
Authors F.O. Javier1, D.H.Q. Thinh2, W. Sriraj3, M.B. Mansor4, C. Irawan5, S.B. Yusak6, J. Kurnianda7, Y.P. Nguyen8, A. Ong-Cornel9, Y. Hadjiat10, H. Moon10
  • 1Pain Management Center, St. Luke's Medical Center, 1102 - Quezon City/PH
  • 2Department Of Radiation Oncology, HCMC Oncology Hospital, 84 8 - Ho Chi Minh City/VN
  • 3Department Of Anesthesiology, Faculty Of Medicine Khon Kaen University, Srinagarind Hospital, 40002 - Khon Kaen/TH
  • 4Department Of Anesthesiology, University of Malaya Faculty of Medicine, 50603 - Kuala Lumpur/MY
  • 5Department Of Internal Medicine, Cipto Mangunkusumo General Hospital (RSCM) University of Indonesia, 10430 - Jakarta Pusat/ID
  • 6Department Of Radiotherapy And Oncology, National Cancer Institute, 62250 - Putrajaya/MY
  • 7Department Of Internal Medicine, Gadjah Mada University/Dr. Sardjito General Hospital, 55284 - Yogyakarta/ID
  • 8Department Of Palliative Care And Pain Management, K Hospital - Vietnam National Cancer Hospital, Hanoi/VN
  • 9-, Veterans' Memorial Medical Centre, 1101 - Quezon City/PH
  • 10Apac Latam Mea, Mundipharma, 018961 - Singapore/SG

Abstract

Background

Inadequate control of cancer pain adversely affects patients’ QoL & daily functioning. Although opioid analgesia is the mainstay of cancer pain treatment, access in SEA is inadequate. Regional data on pain management practice is also scarce. This study aimed to identify patterns of analgesic prescription among symptomatic patients with cancer in 6 SEA countries, & explore relationships with pain control, treatment satisfaction & QoL.

Methods

This cross-sectional observational study included 465 adult outpatients prescribed analgesics for cancer pain for ≥1 month at 22 sites in Indonesia, Malaysia, Philippines, Singapore, Thailand & Vietnam. Data on analgesic prescription, cancer characteristics & treatment were extracted from medical records. Subjects’ & investigators’ satisfaction with pain control, adequacy of analgesia, QoL (EuroQol Group 5-Dimension Self-Report Questionnaire 3 Level, EQ-5D-3L), pain intensity & sleep disturbance were recorded via questionnaires.

Results

Most subjects (84%) had stage III or IV cancer; 66% had metastatic disease. 419 subjects (90%) were prescribed opioids; of these, 42% received weak opioids & 58% received strong opioids. Over half (54%) of all subjects received both opioids & non-opioids. Most investigators (71%) assessed analgesia as “adequate” for pain control. In contrast, subjects’ mean±SD worst pain intensity over 24h was 4.8±2.5 on a scale of 0/no pain to 10/worst possible pain; their mean±SD current pain intensity was 4.1±2.6. Moreover, though 60% of subjects reported being “satisfied” with their level of pain control, a surprisingly high percentage had problems with pain/discomfort (82%), usual activities (66%) & anxiety/depression (56%). Over half (55%) reported sleep disturbance due to pain in the past 7 days.

Conclusions

Despite the 90% overall prescription rate for opioids and 60% reported satisfaction rate with pain control in this study, many subjects still reported unrelieved pain, QoL issues & sleep disturbance due to pain. The results suggest that current prescription practice in SEA may be inadequate & highlight a surprising contrast between subjects’ reported satisfaction with pain control & their experiences with consequences of pain.

Clinical trial indentification

NCT02664987

Legal entity responsible for the study

Mundipharma Pte Ltd

Funding

Mundipharma Pte Ltd

Disclosure

F.O. Javier: Served as a speaker for Mundipharma and Eli Lily Philippines. M.B. Mansor: Received a travel grant from Fresenius Kabi to attend a conference. Y. Hadjiat, H. Moon: Employee of Mundipharma Pte Ltd. All other authors have declared no conflicts of interest.