痛みと緩和のジャーナル

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Collaborative Efforts May Improve Chronic Non-Cancer Pain Management in Asia: Findings from a Ten-Country Regional Survey

Chi Wai Cheung*, Chee Yong Choo, Yong-Chul Kim, Feng Sheng Lin, Seong-Hwan Moon, Evelyn Osio-Salido, Sheng-Fa Pan, Vivek Ajit Singh, Seung-Hwan Yoon, Lois Ward, Hanlim Moon and Abhishek Bhagat

Background: The objective of the ACHEON survey was to investigate current practices in chronic non-cancer pain (CNCP) management in Asia, with a focus on opioid use.

Methods: A questionnaire-based survey conducted in 10 Asian countries/regions was answered by 695 physicians managing pain (median experience: 15 years) and 1,305 patients experiencing CNCP within the preceding 3 months.

Results: Overall, 89.3% of patients reported experiencing moderate-to-severe pain (median pain duration of 24 months). Continuing pain management education of ≤10 hours was reported by 71.1% of the physicians. While approximately 80% of physicians reported quantifying pain in practice, 65.0% of patients reported that no scale was used for their pain assessment. A significant proportion of physicians (78%) perceived discordance between their patients’ actual pain level and their own evaluation. Opioids were considered necessary for CNCP management by 63.6% of physicians. However, while non-opioid oral medication was prescribed to 66.8% of patients, only 4.4% of patients were prescribed opioids. CNCP was reported to affect activities of daily living for 80.8% of patients. Physicianperceived barriers to optimal therapy included patients’ reluctance to use opioids owing to fear of adverse effects (65.0%) and addiction (64.9%), while physicians’ reluctance to prescribe opioids (63.7%) was partially attributable to inadequate pain assessment (60.9%) and excessive regulation of opioids (57.3%).

Conclusion: While the majority of patients surveyed reported moderate-to-severe CNCP, opioid use was suboptimal. Physician and patient education to address stigmas associated with opioid use may improve pain management practices in these countries.