Management of cancer pain in Primary Care in Poland

Cancer pain remains a big challenge to modern medicine. General Practitioners (GPs) supported by Palliative Care teams play a key role in the care of terminally ill cancer patients. The quality of pain management depends very much on GPs' knowledge and skills.
The aim of this study was to assess GPs' knowledge about pain management.
The questionnaire with clinical situations based on recommended guidelines connected with pain management was sent to all GPs within the Kujawsko-Pomorski and Podlaski provinces.
The response rate was 51%. The GPs in Kujawsko-Pomorski province had better access to palliative care for their patients. In the whole sample, the median of appropriate responses to eight questions equalled 4. The biggest percentage of correct answers (85.6%) was given to question concerning the characteristic of neuropathic pain. Besides, more than 50% of correct answers were given to questions which concerned the breakthrough pain (54.4%) and pain management of an unconscious patient (56.9%). The lowest percentage of correct answers (24.6%) concerned the conversion of oral to subcutaneous opioids in case of vomiting and reappearance of intensive pain.
The results of this study indicate a considerable difference between the official guidelines and every day practice of pain management.
The results underline also the need for changes in vocational training of general practitioners, with special emphasis on pain management in terminally ill patients.
 
Słowa kluczowe: cancer pain, opioids, General Practitioners, Pain managements, Cancer Pain Guidelines

Źródło: http://www.viamedica.pl/