Main Article Content
Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a result of pain management at Srinagarind Hospital, Khon Kaen University following the implementation of World Health Organization (WHO) Pain Guideline. Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the-clock and 3) analgesics used for break-through pain for patients receiving strong opioids. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled, 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. In Naïve group (n=159), 32.7% (n=52) of patients were given analgesics following the WHO on both day 1 and day 3 of admissions; 3.8% (n=6) of patients followed WHO only on day 1; 23.3% (n=37) of patients followed WHO only on day 3 whereas 40.2% (n=64) of patients did not follow WHO on both days. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO both days on day 1 and a decreased pain score was much improved (3.9, SD±1.8) as continuing to follow WHO on day 3 (p < 0.0001) compared to those not following WHO on both days. In Routine group (n=102), 31.4% (n=32) of patients were given analgesics following WHO guideline on both day 1 and day 3 of admission. 5.9% (n=6) of patients followed WHO only on day 1; 27.5% (n=28) of patients followed WHO only day 3 while 35.3% (n=36) of patients did not follow WHO on both days. A decreased pain score was statistically significant greater (2.6, SD±1.8) in a routine group following the WHO both days on day 1 (p < 0.0001). Furthermore, a decreased pain score was even greater (3.9, SD±2.3) in the routine group continuing to follow WHO on day 3 compared to those not following WHO on both day 1 and day 3 of admission. The most common of adverse effects related to analgesics was constipation. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO regardless the history of analgesics exposure.
In the case that some parts are used by others The author must Confirm that obtaining permission to use some of the original authors. And must attach evidence That the permission has been included
Attasara p. Cancer Registry 2005. National Institute of Health, Department of Medical Services, Ministry of Public Health, Thailand. Avaible from http://www.nci.go.th/cancerrecord/cancer_rec1.html Accessed on October 15, 2006.
Bral EE. 1998. Caring for adults with chronic cancer pain. Am J Nurs 98(4): 26-32.
Breitbart พ. 1994. Psycho-oncology; depression, anxiety, delirium. Semin Oncol 21(6); 754-69.
Cleeland cs, Nakamura Y, Mendoza TR, et al. 1996. Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain 67(2-3): 267-273.
Foley KM. 1985. The treatment of cancer pain. N Engl J Med 313(2): 84-95.
Frame D, Paice J, Shott S, et al. 2000. Incidence and management of pain in an inpatients oncology unit. Proc Am Soc Clin Oncol 19: (abstr 2405).
Ger LP, Ho ST, Wang JJ, et al. 1998. The prevalence and severity of cancer pain: a study of newly-diagnosed cancer patients in Taiwan. J Pain Symptom Manage 15(5): 285-293.
Grond S, Zech D, Diefenbach c, et al. 1996. Assessment of cancer pain: a prospective evaluation in 2266 cancer patients referred to a pain service. Pain 64(1); 107-114.
Hammack JE, Loprinzi CL. 1994. Use of orally administered opioids for cancer-related pain. Mayo Clin Proc 69(4): 384-390.
Higginson IJ, Hearn J. 1997. A multicenter evaluation of cancer pain control by palliative care teams. J Pain Symptom Manage 14(1); 29-35.
Landis SH, Murray T. Bolden S, et al. 1999. Cancer statistics. CA Cancer J Clin 49(1): 8-31.
Sriplung H, Sontipong ฆ, Martin N, et al. 2003. Cancer in Thailand Vol. lll, 1995-1997. Bangkok Medical Publisher, Bangkok.
Steward BW, Kleihues p. World Health Organization; World Cancer Report 2003. International Agency for Research on Cancer. http://www. iarc.fr/WCR/. Accessed on October 15, 2006
Stjernsward J, Colleau SM, Ventafridda V. 1996. The World Health Organization Cancer Pain and Palliative Care Program. Past, present, and future. J Pain Symptom Manage 12(2): 65-72.
Thienthong ร, Pratheepawanit N, Limwattananon c, et al. 2006. Pain and quality of life of cancer patients: a multi-center study in Thailand. J Med Assoc Thai 89(8): 1120-1126.
Vatanasapt V, Sripun S, Tailerd J, et al. 1992. Incidence of cancer pain in Khon Kaen, Thailand. Thai Cancer J 18: 64-70.
World Health Organization. Fact sheet: Cancer. http://www.who.int/topicsycancer/en/. Accessed on October 15, 2006.
Zech DF, Grond S, Lynch J, et al. 1995. Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study. Pain 63(1): 65-76.