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Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis.

Publication ,  Journal Article
Kwekkeboom, K; Serlin, RC; Ward, SE; LeBlanc, TW; Ogunseitan, A; Cleary, J
Published in: Pain
June 1, 2021

Patient fear of addiction is a well-documented barrier to the use of analgesic medications for cancer pain control. Over the past 2 decades in the United States, an "opioid crisis" has arisen, accompanied by risk messages delivered through news outlets, public health education, and patient-provider communication. The purpose of this study was to determine if patient-related barriers to cancer pain management-specifically, fears of addiction-and related pain outcomes (pain severity, pain interference with daily life, and adequacy of pain management) have worsened over the last 20 years. A sample of 157 outpatients with active recurrent or active metastatic cancer completed the Barriers Questionnaire-II (BQ-II) and measures of pain and analgesic use. We identified 7 comparison studies published between 2002 and 2020 that reported patient-related barriers using the BQ-II. Significant linear relationships were found between later year of publication and greater fear of addiction (harmful effect subscale score, B = 0.0350, R2 = 0.0347, F1,637 = 23.19, P < 0.0001) and between year of publication and more pain management barriers overall (total BQ-II score, B = 0.039, R2 = 0.065, F1,923 = 73.79, P < 0.0001). Relationships between BQ-II scores (harmful effect and total) and pain outcomes did not change over time. Despite worsening in patient-related barriers, the proportion of patients with adequate vs inadequate analgesic use did not differ over time. Notably, 40% of participants reported inadequate analgesic use, a statistic that has not improved in 20 years. Additional research is necessary to clarify factors contributing to changing beliefs. Findings indicate a continuing need for clinical and possibly system/policy-level interventions to support adequate cancer pain management.

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Published In

Pain

DOI

EISSN

1872-6623

Publication Date

June 1, 2021

Volume

162

Issue

6

Start / End Page

1840 / 1847

Location

United States

Related Subject Headings

  • Pain Management
  • Pain
  • Opioid Epidemic
  • Neoplasms
  • Humans
  • Cancer Pain
  • Anesthesiology
  • Analgesics
  • 52 Psychology
  • 42 Health sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Kwekkeboom, K., Serlin, R. C., Ward, S. E., LeBlanc, T. W., Ogunseitan, A., & Cleary, J. (2021). Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis. Pain, 162(6), 1840–1847. https://doi.org/10.1097/j.pain.0000000000002173
Kwekkeboom, Kristine, Ronald C. Serlin, Sandra E. Ward, Thomas W. LeBlanc, Adeboye Ogunseitan, and James Cleary. “Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis.Pain 162, no. 6 (June 1, 2021): 1840–47. https://doi.org/10.1097/j.pain.0000000000002173.
Kwekkeboom K, Serlin RC, Ward SE, LeBlanc TW, Ogunseitan A, Cleary J. Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis. Pain. 2021 Jun 1;162(6):1840–7.
Kwekkeboom, Kristine, et al. “Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis.Pain, vol. 162, no. 6, June 2021, pp. 1840–47. Pubmed, doi:10.1097/j.pain.0000000000002173.
Kwekkeboom K, Serlin RC, Ward SE, LeBlanc TW, Ogunseitan A, Cleary J. Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis. Pain. 2021 Jun 1;162(6):1840–1847.

Published In

Pain

DOI

EISSN

1872-6623

Publication Date

June 1, 2021

Volume

162

Issue

6

Start / End Page

1840 / 1847

Location

United States

Related Subject Headings

  • Pain Management
  • Pain
  • Opioid Epidemic
  • Neoplasms
  • Humans
  • Cancer Pain
  • Anesthesiology
  • Analgesics
  • 52 Psychology
  • 42 Health sciences