Patients’ and physicians’ perspectives on opioid therapy for chronic cancer and musculoskeletal pain in Germany, Italy, and Turkey: PAin RESearch (PARES) survey

Abstract

Objective:

Under-treatment or lack of appropriate treatment for chronic pain remains an ongoing major healthcare problem. Opioids are being increasingly recognized as an effective option for chronic pain management. The objective of this survey was to understand the perspective of patients treated with opioids on quality of treatment, preferences, and possibilities to improve treatment and communication between patients and physicians.

Research design:

A large-scale PAin RESearch (PARES) survey of 2860 patients (Germany, Italy, and Turkey) with chronic cancer or musculoskeletal pain prescribed opioid therapy was conducted to assess various factors such as ease of use and compliance, sleep, quality-of-life, and polymedication. A physician component was also included. Relationships between variables and differences between groups were tested using Spearman and Wilcoxon signed-rank tests, respectively.

Results:

Of the patients surveyed, 61% received strong opioids (WHO III) and 39% weak opioids (WHO II). Nearly 65% of the patients were currently on a twice daily or more dosing schedule; however, 61.5% of the patients responded that they considered once-daily dosing to be the most convenient schedule. Patients’ responses indicated that different dosing schedules significantly influenced the occurrence of end-of-dose pain, feeling limited by the remaining level of pain, problems in falling asleep, and episodes of waking up at night or early in the morning. Physicians’ responses showed that they were not surprised by 68.5% of patient responses; they also felt the need to change some aspect of pain treatment for a third of the patients, the commonest being pain medication (52.4%).

Conclusions:

The results of the survey suggest that patients prefer a convenient dosing scheme, which may have a positive impact on compliance. Physicians may have to communicate more closely with patients about their needs.

Keywords::

• Cancer pain
• Chronic non-malignant pain
• Dosing schedule
• End-of-dose pain
• Opioids
• Polymedication
• Sleep

Transparency

Declaration of funding

Funding for this study was provided by Janssen-Cilag GmbH.

Declaration of financial or other relationships

Antonie M. Wimmer and Antje Eggers have disclosed that they are employees of Janssen. Renato Vellucci has received consultation fee/honorarium from Grunenthal and Astellas Pharma S.p.A. Joachim Dejonckheere, a consultant for SGS life sciences services, conducted the statistical analysis. Gerhard H. H. Müller-Schwefe, has no relevant relationships to declare. CMRO Peer Reviewers on this manuscript have no relevant financial relationships to disclose.

Acknowledgments

Medical writing services were provided by Cactus Communications. The authors are fully responsible for all content and editorial decisions.

Previous presentations

Presented as posters at the 7th Congress of the European Federation of IASP® Chapters (EFIC®), Hamburg, Germany, September 21–24, 2011.