Factors influencing pain therapy for metastatic cancer patients in Bosnia and Herzegovina

Abstract

Objective. To investigate cancer pain management and evaluate factors that could be addressed and lead to potential improvement of pain therapy. Materials and methods. Two hundred patients with metastatic cancer pain at the Department of Oncology, University Hospital Mostar, completed questionnaires about cancer pain treatment. Thirty oncologists from the Cancer Institute, University of Sarajevo and the Department of Oncology, Clinical Hospital, Mostar were asked to complete the questionnaire about cancer pain management. Results. Compliance for analgesics was statistically better (p=0.013) for patients who were regularly asked about pain than for those patients who were asked periodically. Nearly twice as many patients, whom the doctor always asked about pain, regularly took medication (65.5% versus 32.8%). There was a statistically significant, positive relationship between regular use of analgesics and the interest of the doctor about pain reduction after initiation of analgesic therapy (p=0.008). Almost half of the patients, 47%, stated that their doctor did not devote enough time to their pain problems during the interview. Statistically significantly more patients took analgesic medication regularly if they were not afraid of narcotics (p=0.006). Numerical or VAS scales in description of cancer pain were used by only 30% of interviewed oncologists. The vast majority of doctors, 86.7%, used opiates for the terminal phase of the illness. Conclusion. Assessment and the treatment of cancer pain in Bosnia and Herzegovina remains inadequate, emphasizing the need for changes to cancer pain patient care.