Cancer patients' knowledge, beliefs, and behavior regarding pain control regimens: Implications for education programs

Abstract

The inadequate control of cancer-related pain is a matter of great concern. Misconceptions about pain medications on the part of professionals and the public have been implicated as causes of this problem. Another cause may be noncompliance with prescribed regimens. A study of 82 cancer patients who were prescribed pain medications was conducted to further investigate the problem of pain control in this population. Patients were interviewed twice: on the day after they received pain prescriptions (T1) and again two weeks later (T2). There was a significant decrease in patients' reported pain between T1 and T2 ( P = 0.0001). By their own report, the level of patients' compliance with prescribed pain control regimens was very high. At T2 77% of the patients recalled the correct names of their pain medications and 88% had been taking them. However, an important gap in patients' knowledge was revealed by their general inability to recall any of the common side effects of pain medications (constipation, nausea, and sedation). None of the measures of pain—pain level at T1 and T2 and change in pain between T1 and T2—was related to the patients' education, age, attending physician, prescribed medication schedule, or medication strength. More women than men reported increased pain during the study period ( P = 0.04). In general, the patients′ concerns about possible addiction or tolerance to prescribed medications were low. However, there was a positive relationship between intensity of pain and concern about tolerance to drugs ( P = 0.0003). The study results suggest several problems related to pain control that may be reduced by educational intervention. First, it appears that better patient-physician communication about pain and pain medications could more appropriately relate patients' pain levels, the strength of medications prescribed, and the medication schedules prescribed. Second, patients' knowledge about their pain-control regimens could be increased. Health educators should be challenged by these findings to develop effective strategies for programs that will improve the quality of life for cancer patients.