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

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% hadmetastatic disease. 419 subjects (90%)were prescribed opioids; of these, 42% receivedweak 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±SDworst pain intensity over 24h was 4.8±2.5 on a scale of 0/no pain to 10/worst possible pain; theirmean±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 problemswith 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.