Fear Of Addiction Research Articles

Exploring women’s perception and attitude towards antidepressant use: a cross-sectional study

BackgroundThe World Health Organization reports that depression affects more than 280 million people globally. Women are approximately 50% more likely to experience depression compared to men. Depression during pregnancy leads to deterioration of the mother’s and the fetus’s health. We aim to explore women’s perceptions and attitudes toward using antidepressants and to identify the factors that influence decision-making regarding antidepressant use.MethodA cross-sectional survey, employing a convenience sampling method, was conducted on a university campus in Riyadh, Saudi Arabia. The survey was developed by the investigators and validated by health practitioners. Answers were reported using a 5-point Likert scale. The responses were summed up to give a total score for each respondent. Respondents who scored above or equal 75% of the total score was considered positive perception or favorable attitude. Binary logistic regression analysis was used to identify factors influencing participants’ perception and attitude toward taking antidepressants.ResultsA total of 991 subjects were surveyed. The majority of women had negative perceptions and favorable attitudes towards using antidepressants during pregnancy reaching 64%. While women with positive perceptions and favorable attitudes represented about 20% of the study subjects. Participants reported that social stigma, religious beliefs, and fear of addiction significantly influenced their attitudes toward antidepressant use.ConclusionsThis study explores women’s perceptions of depression and antidepressant use, revealing that a significant proportion of Saudi women have a negative perception. The research emphasizes the need for tailored awareness programs to promote informed decision-making regarding antidepressant usage among Saudi women.

Developing an Evidence-Based Patient Education Guide on Pain Management for Asian Patients on Hospice.

Asian Americans are the fastest-growing racial group in the United States. This article describes the development of a pain management assessment guide for Asian patients on hospice, their families, and their nurses. Thematic analysis was used to evaluate the applicability of research on pain, pain management, and barriers to pain management from primarily Asian countries to Asian patients on hospice in the United States. Thematic analysis of interviews with such patients concurs with research findings. Four themes emerged: enduring pain, preference for Chinese medicine remedies, fear of addiction, and concern about the side effects of pain medications. Interviews with experienced hospice nurses also aligned with these themes. Hospice nurses were asked to share their strategies for assessing and managing pain among their Asian hospice patients. Thematic analysis of their interviews revealed six strategies: focusing on treatment goals, involving family and caregivers, explaining the physiology of pain, explaining the progression of pain medications, addressing concerns about addiction, and managing the side effects of medications. The themes that emerged from patient and hospice nurse interviews were used to develop an evidence-based pain management assessment guide to support Asian patients on hospice, their family, and the nurses who care for them.

Assessment of neuropathic pain management knowledge, attitudes, and practices among urology trainees and consultants in prostate cancer care: a survey-based study

BackgroundEffective neuropathic pain management is crucial in improving the quality of life for patients with prostate cancer. There is an abundance of research about cancer pain and guidelines that have been developed by World Health Organization including the analgesia stepladder, yet patients with cancer pain are still sub optimally analgesed. This is due to a variety of both patient and physician factors which include: lack of knowledge on the use of adjuvant medication, fear of addiction and poor characterization of the type of pain. This study intended to assess the knowledge, attitudes, and practices of urology trainees and consultants in the the context of neuropathic pain in prostatecancer care.MethodsThe study involved 91 urologists, comprising of junior registrars, medical officers and experienced specialists who are members of the South African Urological Association (SAUA). Data was collected through a 25-question web-based survey. The survey covered: demographic information, knowledge, attitudes, and practices related to cancer pain management.ResultsThe study revealed that a significant proportion of urologists assessed neuropathic pain reactively, with only 8% of respondents being familiar with screening scales. Approximately, one-third preferred referrals, and 74% expressed confidence in self-treatment. Concerns regarding opioid prescription were observed in 40.4% of respondents. Furthermore, the usage of adjuvant medications was limited, with only 35% proficiently combining analgesia and adjuvants. Notably, 65% continued to escalate analgesic monotherapy.ConclusionEffective neuropathic pain management in prostate cancer care necessitates a multidisciplinary approach, comprehensive assessment and expertise in adjuvant medication usage. The discrepancies observed among urologists are likely due to variations in experience levels. The study identifies knowledge gaps and suboptimal practices in neuropathic pain management among urologists. Addressing these issues through education, awareness, and interdisciplinary collaboration is imperative to enhance patient outcomes and improve the quality of life for individuals with prostate cancer. This study underscores the need for improved education and interdisciplinary collaboration among urologists in managing neuropathic pain among prostate cancer patients. Enhancing these aspects is essential to achieve better patient outcomes and overall quality of life.

Exploring health professionals' knowledge of cancer-related pain: a scoping review.

Cancer-related pain is a complex multidimensional experience that affects all aspects of life. To support those impacted by cancer-related pain it is essential that health professionals have adequate knowledge in its assessment and management. To explore the knowledge of health professionals regarding cancer-related pain. A scoping review methodology was used to systematically search the literature published between 2010 and 2020. Databases CINAHL, Medline and PsycINFO were searched using terms 'cancer pain', 'healthcare professional', 'knowledge', 'attitudes' and 'barriers'. The search identified 38 articles. They focused on nursing knowledge with minimal involvement of allied health professionals. Knowledge levels were variable with the majority demonstrating poor knowledge. Common knowledge gaps included around fear of addiction, principles of cancer-related pain assessment and management, and interventional techniques. Knowledge of cancer-related pain is variable with several knowledge gaps. More work is needed to ensure health professionals have adequate knowledge regarding the complexity of cancer-related pain.

Perceptions on Use of Opioids in Palliative Care of Dyspnoea in Patients with Fibrotic interstitial lung disease and Chronic Obstructive Pulmonary Disease: A Qualitative Study.

Many patients with chronic obstructive pulmonary disease and fibrotic interstitial lung disease suffer from severe dyspnea and reduced quality of life, despite receiving optimal disease-modifying treatment for their illness. Studies have suggested that these patients may benefit from treatment with low-dose opioids. However, many patients decline opioid treatment. This has led to patients not receiving proper palliative treatment of their lung disease. To identify potential barriers that prevent patients from receiving adequate palliative care with opioids and enable doctors to address patients' concerns. A qualitative study based on semi-structured interviews. Interviews were transcribed and thematic analysis was done using NVivo. Patients were recruited when scheduled for out-patient follow-up at Center for Rare Lung Diseases or at the COPD clinic, Aarhus University Hospital. Eligible patients were 18years of age, did not currently receive opioids or had ever received opioids for dyspnea. A total of 28 patients participated. One patient was excluded before final analysis of 27 patients. Four themes were identified: Fear of side-effects, Need for more information, Stigma of opioids association with severe illness and dying, and No discernible barriers. Furthermore, three sub-themes to Fear of side-effects were identified: Fear of addiction, concern for sedative effect, and fear for loss of mobility due to inability to drive a car. The most expressed concern was Fear of side-effects, especially addiction. Pre-conceived notions about opioids prevent some patients with chronic obstructive lung disease or interstitial lung disease from receiving palliative care for breathlessness.

Views and experiences of opioid access amongst palliative care providers and public representatives in a low-resource setting: A qualitative interview study.

Opioids (e.g. morphine) are affordable, effective interventions for cancer-related pain. However, equity of access to this key medication remains a global challenge, particularly in low- and middle-income countries. We aimed to explore views of palliative care providers and public-representatives about opioid analgesia access in two States in India. We conducted a qualitative study using semi-structured interviews. Transcribed audio-recordings were subjected to thematic analysis using a Framework Approach. Palliative care providers and public-representatives were purposively sampled from services reporting consistent opioid availability and prescribing (≥4kg per annum) from Karnataka and Kerala. Twenty participants (doctors (10), nurses (4), pharmacists (2), service managers (2) and public-representatives (2) were interviewed. Three themes were identified: 1) Attitudes and awareness: opioid treatments are perceived as end-of-life (last days/weeks) interventions; fears of addiction and misunderstanding of pain management goals limit access. 2) Expected and unexpected inequities: patients/carers from lower socioeconomic strata accept doctor recommendations if opioids are affordable, more educated patients/families have reservations about opioids, delay access and perceive expensive medicines as better. Non-palliative care specialist doctors have negative entrenched views and require specialist training. 3) Experiential learning-positive experiences can positively alter attitudes (e.g., participants in Kerala report improved attitudes, awareness and understanding influenced by exposure and community awareness, but experience can also reinforce perceptions as end-of-life care. Entrenched negative views are reinforced by poor experiences while positive experiences improve attitudes. To promote access, opioid prescribing must be needs-based rather than prognosis-based. Addressing the lack of training for non-palliative care workforce would help overcome a major barrier.

Patient's perceptions of buprenorphine use receiving treatment for cancer.

To assess knowledge and attitudes toward opioids and buprenorphine (BUP) of patients with cancer. Single-site, single-intervention telephone survey of patients under palliative care at the cancer center. Forty percent of the participants recognized the word "buprenorphine," and 28 percent recognized BUP indication for addiction treatment. Four percent addressed potential BUP misuse. None recognized BUP indication for pain. Seventy-one percent were not worried about addiction or dependency while using opioids to treat their cancer-related-pain, and 73 percent were not worried about being stigmatized in the healthcare setting about their pain regimens. Patients on opioids for less than 3 months were most strongly correlated with the fear of addiction and stigma. This study identifies patients' knowledge gap regarding BUP products for pain, which gives professionals the opportunity to provide education. This study identified that patients are most worried early on about addiction and stigma when using opioids.

Exploring the barriers and triggers towards the adoption of low- and no-alcohol (NOLO) wines

Alcohol consumption has been declining in Australia over the last 15 years, mostly driven by younger generations, who are reducing or eliminating their alcohol intake to improve their health and for fear of addiction . With more risks associated with drinking alcohol, people are turning to alternative ways of drinking , including low- and no-alcohol (NOLO) wines. Despite this, little is known about the barriers and triggers towards the adoption of NOLO wines from a consumer’s point of view. In addition, the studies published on the topic have collected data from samples of wine drinkers, thus failing to bring in the perspective of non-drinkers, who represent another potential target market for no-alcohol wines. In response to this knowledge gap, the present study proposes a theoretical model using the Theory of Consumption Values to understand consumers’ attitudes toward NOLO wines and advise the wine industry and policymakers to guide more effective decisions on marketing NOLO wines to consumers. We collected data from a representative sample of 712 Australian consumers, split between drinkers and non-drinkers. Results show that functional consumption value had a statistically significant effect on drinkers and non-drinkers, whilst situational and social consumption values do not. The emotional and epistemic consumption values have a statistically significant effect only on drinkers. Both drinkers’ and non-drinkers’ attitudes toward NOLO wines had a positive, statistically significant effect on purchase intention and word-of-mouth (WOM). Wine knowledge did not moderate the relationship between attitudes, purchase intention and WOM.

Experiences with pain management for survivors of complex cancers: Focus on opioids and cannabis.

12118 Background: Survivors of complex cancers often experience pain. Clinical practice guidelines for pain management in cancer survivors cautiously recommend opioids and cannabis for subgroups with certain pain phenotypes, despite limited evidence regarding benefits and harms in survivor populations. We aimed to better understand pain management for these survivors, focusing on attitudes toward, and experiences with, opioids and cannabis. Methods: We conducted 7 90-minute focus groups with 26 disease-free survivors of head and neck and lung cancer who still experience cancer-related pain. Multiple coders conducted thematic analyses to identify themes regarding 1) experiences with post-treatment pain and pain management and 2) utilization, benefits, and harms of post-treatment cannabis and opioids. Results: Survivors (7-35 months from treatment completion) experienced post-treatment physical and psychological pain that affected multiple aspects of their daily life. Since treatment completion, 69% used opioids previously and 8% currently using. Fifty-four percent had used any cannabis product since treatment completion, and 35% currently use cannabis. While some survivors experienced no pain management challenges, others enumerated various difficulties, including fears of addiction to opioids or cannabis, perceived stigma around both products, and access challenges around provider attitudes, cost and insurance coverage, and legality. Survivors reported that providers did not know how to advise about cannabis; for example: “When I talked [to providers] about marijuana they didn’t want to talk about it. They couldn’t recommend it because there’s no clinical data.” Opioids were often perceived as critical to pain management but came with unpleasant side effects. Cannabis was effective at reducing both pain and anxiety for many, but not all, survivors. For some, cannabis reduced anxiety, which in turn reduced pain: “It just keeps my mind occupied enough where I’m not thinking of pain.” Reducing anxiety also helped some survivors eat: “I have a lot of anxiety around eating because I have a fear of choking, so sometimes it helps that.” Survivors described a balance of benefits and harms of opioids and cannabis; for example: “Where [the doctor has] me now...if I go down any lower, it's not going to work. If I go up any higher, I'm going to be not able to function.” Conclusions: Post-treatment survivors of complex cancers continue to experience cancer-related pain, both psychological and physical, for which both opioids and cannabis present a complex set of harms and benefits that vary across survivors. Providers who care for cancer survivors should be aware of the interplay between psychological and physical pain, patient concerns and stigma around opioids and cannabis, and nuances of the harms, benefits, and access issues regarding these treatments.

Comparing Medication Non-adherence in Cardiovascular Disease Patients at Public and Private Hospitals in Peshawar: A Cross-Sectional Study of Prevalence and Contributing Factors.

Introduction The incidence of cardiovascular diseases continues to increase, becoming one of the leading causes of mortality globally. The proper use of medication can greatly reduce the death rate by slowing the progression of the disease. Yet, many patients struggle with following their medication regimen due to various reasons. Effective treatment management relies on patients'self-care and understanding of their illness and medications, which can impact their adherence to taking their prescribed drugs.The objective of the study was to determine the prevalence of medication non-compliance among patients in two public and private tertiary care hospitals in Peshawarand to identify the factors that contribute to this behavior. Material and methods A comparative cross-sectional study design was employed for the research. The study was conducted at Hayatabad Medical Complex and Rehman Medical Institute in Peshawar, as these two hospitals provide care for a significant proportion of cardiovascular disease patients in the area. To assess adherence, a quantitative scale was devised with scores of 8 considered high adherence, scores between 6 and 7 considered medium adherence, and scores below 6 considered low adherence. The factors impacting medication non-adherence were analyzed using a self-administered questionnaire, which was developed following a preliminary study conducted at both hospitals. Results In total, 168 eligible patients from the two hospitals were given the questionnaire. Out of these patients, 107 (63.7%) were male, and 61 (36.3%) were female, with ages ranging from 19 to 84 and a mean age of 55.33. The level of medication adherence was calculated among the participants, with 20.2% reporting high adherence, 22.6% reporting medium adherence, and 57.1% reporting low adherence. The results showed that monthly income (p = 0.006), the presence of co-morbidities (p = 0.002), and the fear of addiction to medication (p = 0.048) were the main factors influencing medication adherence. In regression analysis with high adherence as the reference category and a 95% confidence interval, hospital affiliation was found to be significantly associated with adherence levels. Conclusions The study found that medication adherence among cardiovascular disease patients in private tertiary care hospitals is generally high. However, the level of adherence was seen to be impacted by the patient's monthly income. In light of this, the government should implement programs to reduce the cost of healthcare provision and increase affordability for patients.

Opioid Prescribing for Osteoarthritis: Cross-Sectional Survey among Primary Care Physicians, Rheumatologists, and Orthopaedic Surgeons.

Opioids are often prescribed for osteoarthritis (OA) pain, despite recommendations to limit use due to minimal benefits and associated harms. This study aimed to assess physicians' practice patterns and perceptions regarding opioids by specialty one year following the Centers for Disease Control and Prevention (CDC) published guidance on opioid prescribing. The 139/153 (90.8%) physicians who reported prescribing opioids in the previous year reported decreased prescribing for mild OA (51.3%, 26.5% and 33.3% of primary care physicians, rheumatologists, and orthopaedic surgeons, respectively), moderate OA (50.0%, 47.1% and 48.1%) and severe OA (43.6%, 41.2% and 44.4%). Prescribing changes were attributed to the CDC guidelines for 58.9% of primary care physicians, 59.1% of rheumatologists, and 73.3% of orthopaedic surgeons. Strong opioids were mostly reserved as third-line treatment. Although treatment effectiveness post-CDC guidelines was not assessed, perceptions of efficacy and quality of life with opioids significantly differed across specialties, whereas perceptions of safety, convenience/acceptability and costs did not. Physicians generally agreed on the barriers to opioid prescribing, with fear of addiction and drug abuse being the most important. Across specialties, physicians reported decreased opioid prescribing for OA, irrespective of OA severity, and in most cases attributed changes in prescribing to the CDC guideline.

Framing Cancer Survivors' Access to and Use and Disposal of Prescribed Opioids Within the Opioid Epidemic.

To explore cancer survivors' access to and use and disposal of opioids in the context of the opioid epidemic. Community-based recruitment strategies were employed for individuals aged 18 years or older who were previously diagnosed with cancer, completed cancer treatment within the past five years, or were cancer free, and who were prescribed opioids for cancer-related pain. This qualitative study used semistructured interviews. Data were analyzed using applied thematic analysis techniques. Themes included the following: (a) restrictive policies affecting opioid access and supply, (b) decreased opioid use because of concerns of addiction and other opioid-related side effects, and (c) lack of clarity on safeguarding and disposal of opioids. Cancer survivors may encounter barriers to opioid access, alter medication-taking behavior over fear of addiction and side effects, and face inadequate education regarding proper disposal of opioids. Nurses can advocate for appropriate access to prescribed opioids, assess opioid-taking behavior, provide education regarding storage and disposal, and implement educational interventions accordingly.

Farmakoterapija kancerskog bola opioidnim analgeticima

Introduction: Selection of analgesics should be based on the World Health Organization (WHO) analgesic ladder, beginning with non-opioid analgesics in combination with adjuvants for mild pain, weak opioids with adjuvants are indicated for moderate pain, while potent opioids, non-opioids and adjuvants are recommended for severe pain. Methods: The facts presented in this paper are expanded by searching for recent literature data in the following index-data-bases: SCI index, PubMed, Google Scholar, Scopus, and by using adequate key words. The idea supporting this paper was to make practice easier for clinicians who are engaged in supportive oncology and to help in adequate and up-to-date malignant pain management in oncology patients in everyday practice. Topic: Initial opioid dose should be low, and long-acting opioid dose should be gradually increased and titrated considering daily requirements of short-acting opioid formulation due to pain breakthrough. It is mandatory for patients on long-acting opioid treatment to be provided with fast-acting medication for breakthrough pain treatment. The following long-acting strong opioids formulations are available in Serbia - oxycodone, oxycodone/ naloxone fixed combination, hydromorphone, tapentadol, fentanyl. A patient and his/her family should be warned about possible side effects of opioids, primarily morphine. There is great fear of prescribing opioid analgesics due to their possible side-effect of tory depression. Opiophobia is defined as exaggerated concern about the consequences of medical use of opioids. The risk of opioids is estimated to overweight the benefits of the treatment, resulting in the fact that they are not used where indicated. Avoiding opioid prescriptions is one of the biggest barriers for successful treatment of cancer pain. Conclusion: Oncology patients with moderate and severe pain have a constitutional right not to tolerate pain and they have a right to strong opioid treatment. Implementation of analgesic elevator is recommended. There should not be any fear of addiction or other side-effects that can be controlled, and the benefits greatly outweigh the risks of possible side-effects in these patients. Cancer pain management should be an equally important element of overall cancer treatment. Only by multimodal and multidisciplinary treatment approach satisfactory analgesic effects may be achieved while minimizing adverse side-effects.

P78. Assessment of preoperative barriers to appropriate opioid use and the ability of these barriers to change after elective spine surgery

<h3>BACKGROUND CONTEXT</h3> Various barriers to appropriate postoperative opioid use have been identified in patients undergoing spine surgery. However, knowledge is limited on whether or not these barriers change as a result of going through the experience of surgery. <h3>PURPOSE</h3> The aim of this study is to assess how barriers to appropriate opioid use change in patients following elective spine surgery. <h3>STUDY DESIGN/SETTING</h3> Retrospective chart review. <h3>PATIENT SAMPLE</h3> Adult patients (18 years old) who underwent elective spine surgery and completed the short version of the Barriers Questionnaire Taiwan (S-BQT) and Patient Reported Outcomes Measures Information System (PROMIS) questionnaires preoperatively and at 1-year postoperative followup. <h3>OUTCOME MEASURES</h3> Opioid barriers score (OBS) derived from the summation of subscores within the S-BQT questionnaire, patient reported comfort with the use of naloxone and confidence in nonopioid medications to effectively manage postoperative pain. <h3>METHODS</h3> A preoperative and 1-year postoperative OBS (0-35) was calculated for each patient using their S-BQT surveys. A high opioid barriers score (hOBS) was defined as a score above the sample 75th percentile (OBS > 16). Postoperative changes in patient reported confidence in nonopioid medications and comfort with the use of naloxone were assessed. Abnormal PROMIS scores were defined as: high pain interference, sleep disturbance, anxiety, depression, fatigue for scores 60; and low physical function and social roles satisfaction for scores 40. Bivariate statistics and multivariate regression were used to assess for factors associated with high OBS and postoperative changes, while controlling for age, sex, Charlson Comorbidity Index (CCI), prior opioid use, procedure and spinal region. <h3>RESULTS</h3> Within 98 patients who met inclusion criteria, there were no differences in preoperative versus postoperative OBS (11.9 ± 6.4 vs 12.2 ± 7.1, p = 0.80). At both time points, fear of addiction was the highest S-BQT subdomain score. Postoperatively, there was an increase in patient reported confidence in nonopioid medications for pain control (p = 0.01), but no changes were observed in confidence with the use of naloxone (p = 0.70). Preoperatively, the odds of having hOBS (OBS >16) were increased with high anxiety (Odds Ratio [OR] 9.8, 95% Confidence Interval [CI] 1.8 - 66.7) and decreased with prior opioid use (OR 0.10, 95%CI 0.02-0.40). Postoperatively, high sleep interference (OR 7.0, 95%CI 1.2 - 44.9), depression (OR 8.7, 95%CI 1.2-82) and low social satisfaction (OR 7.5, 95%CI 1.3 -54.3) were associated with increased odds of developing hOBS in patients with previously normal barrier scores (OBS <16). <h3>CONCLUSIONS</h3> No significant changes in barriers to appropriate opioid use or patient reported comfort with naloxone were observed following the experience of spine surgery. These findings underscore the need for standardized preoperative opioid counseling to promote safe and appropriate opioid use following surgery. Patients with high levels of anxiety are likely to benefit most from these sessions as they may be predisposed to having significant barriers to appropriate postoperative opioid use. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Manifestations of Opioid Stigma in Patients With Advanced Cancer: Perspectives From Patients and Their Support Providers.

Stigma surrounding prescription opioids, or opioid stigma, is increasingly recognized as a barrier to effective and guideline-concordant cancer pain management. Patients with advanced cancer report high rates of pain and prescription opioid exposure, yet little is known about how opioid stigma may manifest in this population. We conducted in-depth qualitative interviews with 20 patients with advanced cancer and 11 support providers between March 2020, and May 2021. We took a rigorous inductive, qualitative descriptive approach to characterize how opioid stigma manifests in the lives of patients with advanced cancer. Patients and their support providers described three primary manifestations of opioid stigma: (1) direct experiences with opioid stigma and discrimination in health care settings (eg, negative, stigmatizing interactions in pharmacies or a pain clinic); (2) concerns about opioid stigma affecting patient care in the future, or anticipated stigma; and (3) opioid-restricting attitudes and behaviors that may reflect internalized stigma and fear of addiction (eg, feelings of guilt). This qualitative study advances our understanding of opioid stigma manifestations in patients with advanced cancer, as well as coping strategies that patients may use to alleviate their unease (eg, minimizing prescription opioid use, changing clinicians, and distancing from perceptions of addiction). In recognition of the costs of undermanaged cancer pain, it is important to consider innovative treatment strategies to address opioid stigma and improve pain management for patients with advanced cancer. Future research should examine opportunities to build an effective, multilevel opioid stigma intervention targeting patients, clinicians, and health care systems.

Clinical and psychosocial factors affecting treatment adherence in children with rheumatic heart disease.

The present study aimed to investigate the outcomes of psychiatric symptoms and family functions on treatment adherence in children, in addition to sociodemographic characteristics and clinical factors related to the disease. The research sample consisted of 43 children who were followed up with rheumatic heart disease diagnosis during the study. Clinical features were obtained from the patient files. The family assessment device evaluating family functioning and the strengths and difficulties questionnaire scale to screen emotional and behavioural problems in children were used. Considering the regularity of treatment in our patients, there were 31 (72%) patients adherent to secondary prophylaxis regularly, 7 (6.9%) patients were partially adherent, and 5 (11.6%) patients non-adherent. Patients were divided into treatment adherent (Group 1) and non-adherent (Group 2). There was no statistically significant impact on treatment adherence whether the patients receive enough information, lifestyle, fear of developing adverse effects, fear of addiction, lack of health insurance, difficulties in reaching the drug or hospital. However, the fear of syringes on treatment adherence had an effect statistically significantly (p = 0.047). Forgetting to get a prescription and/or take the drug when the time comes was statistically higher in the non-adherent group (p = 0.009). There was no statistically significant effect of psychosocial factors on treatment adherence between groups. Providing an effective active recall system, involving primary care workers, providing training on the disease and its management, and a comprehensive pain management programme can improve the process, especially for cases where secondary prophylaxis is missed.

Women’s Perception and Attitude Towards Using Antidepressants During Pregnancy: A cross sectional study

IntroductionDepression during pregnancy leads to deterioration of the mothers’ and the fetus’ health.ObjectivesTo explore women’s perception and attitude towards using antidepressants during pregnancy and identify the factors that influence decision making regarding antidepressants use.MethodsA cross-sectional survey of 991 subjects using convenient sampling. All study subjects (PNU affiliates; staff and students) were invited to fill out an electronic questionnaire, KAAUH staff and PNU female associates who were less than 18 years old were excluded. Answers were reported using 5- point Likert scale. The responses were summed up to give a total score for each respondent. The cutoff point is 75%. Respondents who scored above or equal 75% of the total score was considered as positive perception or favorable attitude.ResultsThe majority of women had negative perception and favorable attitude towards using antidepressants during pregnancy reaching 64%. While, women with positive perception and favorable attitude represented about 20% of the study subjects. The main factors influencing decision making were, education specialty (health, none-health) and subject history of diagnosis with any psychological disorder. Social stigma, religious believes and fear of addiction were reported by surveyors to be the reason influencing their perception and attitude about antidepressants use (P value &lt;0.005).ConclusionsThis study reveals that although Saudi women reflect a negative perception towards using antidepressants during pregnancy, yet they have a favorable attitude once depression during pregnancy becomes an issue.DisclosureNo significant relationships.

Prevalence and management of pain in lung cancer patients in northern China: A multicenter cross-sectional study.

BackgroundPain is a fearful yet common symptom among lung cancer patients. This multicenter, cross‐sectional study was conducted to examine the current status of pain prevalence and management in lung cancer patients in northern China.MethodsA total of 18 hospitals across northern China were selected. Patients with primary lung cancer who visited the outpatient clinic or were admitted in the wards on a preplanned day were invited to complete a questionnaire. Meanwhile, physicians who had experience of treating primary lung cancer patients were also surveyed.ResultsA total of 533 patients and 197 physicians provided valid responses to the survey, of which 45.4% (242/533) of patients reported pain during the course of disease and 24.2% (129/533) of patients had experienced pain within the past 24 h. The mean average pain intensity by the brief pain inventory was 3.47 ± 1.55. The binary logistic regression analysis showed female gender and stage IV disease were significantly associated with the presence of pain. A total of 74.4% (96/129) of patients reporting pain within 24 h were taking analgesics. The most common reason for patients not using analgesics was that the pain was tolerable (48.2%), while the most common barriers to prescribing opioids as reported by physicians were fear of adverse reactions (43.7%) and fear of addiction (43.1%).ConclusionDespite recognition of the importance of pain control by most physicians and an improvement in cancer pain management, inadequate treatment of cancer pain still exists in lung cancer patients in northern China. High‐quality pain education for both patients and physicians is needed in the future.

Evaluating Pain Management Practices for Cancer Patients among Health Professionals: A Global Survey

Background: Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries. Objective: To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs. Design: Descriptive survey. Setting/Subjects: Fifty-six countries worldwide; convenience sample of 1639 consisted of 36.8% physicians; 45.1% nurses, and 4.5% pharmacists employed in varied settings. Results: Improved pain management services are key elements. Top barriers include religion factors, lack of appropriate education and training at all levels, nonadherence to guidelines, patients' reluctance to report on pains, over regulation associated with prescribing and access to opioid analgesics, fear of addiction to opioids, and lack of discussions around prognosis and treatment planning. Conclusion: The majority of patients with cancer in low-income countries are undertreated for their pain. Promoting cancer pain accredited program of training and education on pain management for physicians and nurses is crucial, as well as advocating policymakers and the public at large.

A Survey of Knowledge and Barriers of Healthcare Professionals toward Opioid Analgesics in Cancer Pain Management.

Purpose Pain is among the most frequent and troubling symptoms in cancer patients. Despite the availability of updated treatment guidelines and effective pharmacological therapies, undertreatment of cancer pain remains a global problem. Opioids are the mainstay analgesics to treat moderate-to-severe cancer pain. The goal of this study was to assess the knowledge and barriers towards opioid analgesics for cancer pain management among healthcare professionals in Oncology Units in Jordan. Methods A structured questionnaire was administered to healthcare professionals (consultant doctors, resident doctors, pharmacists, and nurses) at three Oncology Units in a cross-sectional study design. Results A total of 201 healthcare professionals completed the questionnaire. The average age was 34.8 ± 8.1 years (range 23–58) and 49.3% of respondents were nurses. The mean score for the knowledge of opioids was 12.5 ± 3.2 out of 24 points (range 2–20). An acceptable level of knowledge was observed in 50.7% of participants, while 49.3% had poor knowledge. Knowledge items mostly answered incorrectly were related to opioid administration, pharmacology, dosing, adverse events, rotation, and toxicity. Knowledge scores were significantly higher for consultant doctors compared to pharmacists and nurses (p=0.016 and p < 0.001, respectively). Healthcare professionals who handled opioid analgesics had significantly higher mean knowledge scores than those who did not (p=0.012). Linear regression analysis revealed that being a consultant physician has an independent, statistically significant association with higher knowledge scores. Among perceived barriers to using opioids, fear of addiction by patients was the most frequently reported barrier by respondents (79.6%). Other highly recognized barriers were fear of adverse effects by patients (67.2%) and lack of training programs on opioid dosing and monitoring (63.7%). Conclusions This study revealed major gaps in the knowledge of opioids and pain management among healthcare professionals. There is an urgent need for developing innovative interventions to improve the knowledge of opioid analgesics and the understanding of pain management guidelines among healthcare professionals in Jordan.