Breaking News
February 24, 2019 - Study reveals insights into how the brain learns new locomotor patterns
February 24, 2019 - Depression Screening: MedlinePlus Lab Test Information
February 24, 2019 - Researchers discover a weakness in a rare cancer that could be exploited with drugs
February 23, 2019 - U.S.-based patient advocacy organizations received majority of pharma donations, finds study
February 23, 2019 - UCL and AIIMS collaborates to increase academic and student exchange
February 23, 2019 - Mechanism behind how diabetes causes muscle loss revealed
February 23, 2019 - Hepatocellular carcinoma diagnosis, prognosis and treatment may improve by identifying a protein
February 23, 2019 - The American Heart Association issues new reference toolkit for healthcare providers
February 23, 2019 - Studies explore physiological dangers that climate change will have on animal life
February 23, 2019 - Penn study reveals increase in health-related internet searches before ER visits
February 23, 2019 - Intensive therapy during early stages of MS leads to better long-term outcomes
February 23, 2019 - Prenatal Fluconazole Exposure Increases Neonatal Risks
February 23, 2019 - Mental Health Screening: MedlinePlus Lab Test Information
February 23, 2019 - Study suggests birth mechanics are part of the process that leads to autism
February 23, 2019 - Unhealthy diet linked to poor mental health
February 23, 2019 - Study gives a snapshot of crocodile evolution
February 23, 2019 - Research finds steep rise in self-poisonings among young people
February 23, 2019 - American Gastroenterological Association announces “AGA Future Leaders Program”
February 23, 2019 - Scientists uncover new mechanisms regulating neural stem cells
February 23, 2019 - Combinations of certain insecticides turn out to be lethal for honeybees
February 23, 2019 - AHA News: Why Are Black Women at Higher Risk of Dying From Pregnancy Complications?
February 23, 2019 - NIMH » Anxiety Disorders
February 23, 2019 - Autistic people urgently need access to tailored mental health support
February 23, 2019 - Newly designed molecule could benefit people with Friedrich’s Ataxia
February 23, 2019 - Chinese CRISPR twins may have better cognition and memory
February 23, 2019 - Study finds new genetic clues associated with asthma in African ancestry populations
February 23, 2019 - Fetal signaling pathways may offer future opportunities to treat lung damage
February 23, 2019 - Early-stage osteoarthritis drug wins prestigious innovation award
February 23, 2019 - Researchers report positive findings with dasotraline for ADHD in children ages 6-12
February 23, 2019 - News study reanalyzes the effects of noncaloric sweeteners on gut microbiota
February 23, 2019 - New device allows scientists to reproduce blow effects on the heart in lab
February 23, 2019 - Holy herb identified as a potential treatment for Alzheimer’s disease
February 23, 2019 - New technology platform digitally counts growth factors in single cells
February 23, 2019 - Physicians still remain at higher risk for burnout compared to other professionals
February 23, 2019 - Surgery and other treatments offer viable options for adult scoliosis
February 23, 2019 - Reduced antibody adaptability may make the elderly more vulnerable to influenza
February 23, 2019 - Researchers find increased rates of CRC screening in Kentucky after Medicaid expansion
February 23, 2019 - Neighborhood income, education associated with risk of disability progression in MS patients
February 23, 2019 - Endocrine Society opposes new rule that restricts access to Title X Family Planning Program
February 23, 2019 - 2019 guidelines for management of patients with atrial fibrillation
February 23, 2019 - Surprise rheumatoid arthritis discovery points to new treatment for joint inflammation
February 23, 2019 - A just-right fix for a tiny heart
February 23, 2019 - UMass Amherst scientist explores role of citrus peel in decreasing gut inflammation
February 23, 2019 - Owlstone Medical and Shanghai Renji Hospital collaborate to initiate breath biopsy lung cancer trial
February 23, 2019 - AMSBIO’s comprehensive portfolio of knock-out cell lines and lysates
February 23, 2019 - New app reliably determines physicians’ skills in forming accurate, efficient diagnoses
February 23, 2019 - Peripheral nerve injury can trigger the onset and spread of ALS, shows study
February 23, 2019 - Researchers uncover mechanisms that prevent tooth replacement in mice
February 23, 2019 - Once-a-day capsule offers new way to reduce symptoms of chronic breathlessness
February 23, 2019 - FDA Adds Boxed Warning for Increased Risk of Death with Gout Medicine Uloric (febuxostat)
February 23, 2019 - Phone-based intervention aids rheumatoid arthritis care
February 23, 2019 - Opioid epidemic makes eastern inroads and targets African-Americans
February 23, 2019 - New identified biomarker predicts patients who might benefit from HER2-targeted agents
February 23, 2019 - Study offers new insights into mechanisms of changes in erythrocytes under stress
February 23, 2019 - Antipsychotic polypharmacy may be beneficial for schizophrenia patients
February 23, 2019 - Researchers investigate how marijuana and tobacco co-use affects quit attempts by smokers
February 23, 2019 - Patients with diabetes mellitus have high risk of stable ischemic heart disease
February 23, 2019 - Transparency on healthcare prices played key role in Arizona health system’s turnaround
February 23, 2019 - A comprehensive, multinational review of peppers around the world
February 23, 2019 - Study finds modest decrease in burnout among physicians
February 23, 2019 - A simple change can drastically reduce unnecessary tests for urinary tract infections
February 23, 2019 - Deep Learning-Enhanced Device Detects Diabetic Retinopathy
February 23, 2019 - Researchers discover new binding partner for amyloid precursor protein
February 23, 2019 - Modest decrease seen in burnout among physicians, researchers say | News Center
February 23, 2019 - Transplanting bone marrow of young mice into old mice prevents cognitive decline
February 23, 2019 - Mogrify to accelerate novel IP and cell therapies using $3.7m USD funding
February 23, 2019 - Johns Hopkins study describes cells that may help speed bone repair
February 23, 2019 - Scientists demonstrate influence of food odors on proteostasis
February 23, 2019 - Researchers unlock the secret behind reproduction of fish called ‘Mary’
February 23, 2019 - Acupuncture Could Help Ease Menopausal Symptoms
February 23, 2019 - Researchers use AI to detect early signs of Alzheimer’s
February 23, 2019 - On recovery, vulnerability and ritual: An exhibit in white | News Center
February 23, 2019 - Memory Stored in Unexpected Region of the Brain
February 23, 2019 - Several health experts worldwide gather at EUDONORGAN event
February 23, 2019 - Discovery of potent compound in native California shrub may lead to treatment for Alzheimer’s
February 22, 2019 - Researchers create new map of the brain’s own immune system
February 22, 2019 - ICHE’s reviews on surgical infections, unnecessary urine tests, and nurses’ role in antibiotic stewardship
February 22, 2019 - UK Research and Innovation invests £200 million to create new generation of AI leaders
February 22, 2019 - Takeda collaboration to boost fight against Alzheimer’s and other neurodegenerative diseases
February 22, 2019 - Heavy drinking may change DNA, leading to increased craving for alcohol
Misconceptions about opioid use undermine pain control among Asian cancer patients

Misconceptions about opioid use undermine pain control among Asian cancer patients

image_pdfDownload PDFimage_print

Misconceptions about the use of strong opioids showed to undermine optimal pain control among Asian cancer patients undergoing chemotherapy and radiotherapy according to a cross-sectional survey conducted at the Sarawak General Hospital in Malaysia.

In a study to be presented at the ESMO Asia 2018 Congress, 133 patients with solid tumours across all stages treated with strong opioids were requested to rate their experience of pain during the week before the delivery of the survey questionnaire by using a visual analogue scale (VAS) from 0-10 and to self-assess the impact of pain on daily activities by completing the Brief Pain Inventory-short form (BPI-sf).
Researchers also investigated types of strong opioids used and patient-related barriers to effective cancer pain management; results were assessed by social determinants including ethnic group, religion and education level.

Overall, a good pain control was reported in 62% of survey participants (pain score < 4) treated with strong opioids usage. "Although levels of pain were improved by more than half in up to 83.5% of patients taking strong opioids --thus confirming effectiveness of these medications, some patient-related barriers still exist", said study author Dr Voon Pei Jye of Sarawak General Hospital. "Fears that strong opioids could damage the immune system and develop addiction were observed as the most common misconceptions, in around 40% of patients. These were followed by the belief that pain could mask the monitoring of cancer progression (23.3%), perceived difficulties in managing side effects of opioids (18.05%), complaints that pain could distract doctors from treating cancer (16.5%), and a fatalistic attitude (5.3%)."

Greater barriers for pain control were found in patients with higher education levels, which may reflect pervasive misconception of opioids use in social media. Fear of harmful effects from taking opioids was observed to be more common in the Malay community, followed by Chinese and Dayak groups. “These differences may reflect some inequities in access to optimal cancer care in the state, however multiple socio-economic factors may also play a critical role in the use of opioids, thus further investigations are needed”, commented Dr Voon.

Although adequate pain relief is core to supportive care, it is still hindered by the lack of availability or accessibility to opioids in some countries, according to Prof Sumitra Thongprasert from Bangkok Hospital Chiang Mai, Thailand, co-chair of the ESMO Asia 2018 Public Policy programme. “Beliefs and other cultural issues may only partially explain a sub-optimal use of opioids analgesics, and several factors remain to be assessed including how information on benefits of these drugs is delivered by health care providers”, she commented. “More importantly, access to prescription of opioids and government restrictions regarding the total amount that a patient could receive each time can significantly influence access and usage patterns among cancer patients.”

Accessibility issues, costs and regulatory barriers that can limit prescribing and dispensing of opioid analgesics in low- and middle-income countries (LMICs) were firstly mapped in 2013 by the Global Opioid Policy Initiative (GOPI) conducted by ESMO with other international partners and which expanded the results of a similar survey conducted in Europe in 2010. Opioid availability was reported to be low in all 20 surveyed countries in Asia, except for South Korea and Japan, and evidence of over-regulation of opioid prescribing was found in the Asia-Pacific region that may restrict or impair access to pain relief treatments. Outcomes from this initiative also highlighted a concrete need to improve palliative care knowledge among clinicians in Asian countries.

“At present, although the availability of critical medications such as opioids, targeted medicines and immunotherapies may be potentially improved in Asia, accessibility issues will be hard to overcome in the next future due to the high costs of cancer treatments”, continued Thongprasert. “Some countries across Asia/Asia-Pacific are simply not able to provide expensive medicines to local communities. Also, in countries where patients have to pay on their own for cancer treatments, high costs of medicines can be the primary reason of poor quality in cancer care.”

Prof. Nathan Cherny from Shaare Zedek Medical Centre Oncology Institute, Israel, at the time co-coordinator of the Global Opioid Policy Initiative for ESMO, added: “According to the results reported in the paper published in 2013, there is agreement between the WHO, the International Narcotics Control Board, and ESMO, and the 20 international and national palliative care and oncology societies collaborating on the project, about the fact that opioid analgesic therapy is the cornerstone of cancer pain management, and that there is no economic barrier to making opioids available for this indication, and that it must be made a public health priority.”

Strategies to improve accessibility to and availability of cancer medicines in LMICs will be discussed in a thought-provoking debate to be held at the ESMO Asia 2018 Congress in Singapore. “Since reducing cancer medicine costs could take some time, other potential strategies need to be assessed, such as the set-up of different pricing according to economic status; pharmaceutical companies providing Patient Access programme or Technology transfer to LMICs to manufacture their own medicines; availability of quality-assured generic and biosimilar medicines; and Compulsory Licensing of anti-cancer medicines. Beyond regulations, major barriers are likely to remain in these countries due to the rapid pace of development of new medicines, limitation of access to research projects and a lack of new technologies.” added Thongprasert.

Global commitment on ensuring access to anti-cancer medicines has increased over recent years and according to ESMO President Josep Tabernero, cooperation among different stakeholders can contribute to better guiding the Asia-Pacific countries towards improving access to and availability of essential medicines, vaccines, diagnostics and medical devices.

“Overall, there is a need to adequately prioritize limited resources to clinical benefits, and collaborative efforts have resulted in new tools and approaches that can play a critical step in addressing policy issues in LMICs. One such platform is the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) which can help governments to review and adjust their respective national medicine lists to ensure that they prioritize the most cost-effective ones that provide the greatest value to patients.”

“Also, by facilitating education and updating of oncology professionals in the Asia-Pacific region, the annual ESMO Asia Congress, launched back in 2014, provides the arena for sharing knowledge as well as discussing and debating major challenges in oncology towards advancing the field and bringing about real and necessary change,” the ESMO President concluded.

Tagged with:

About author

Related Articles