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U.S. Oncologists Rate Selves Highly in Pain Management

But, acknowledge barriers to optimal care, and consider quality of training to be poor

TUESDAY, Nov. 15 (HealthDay News) -- Although U.S oncologists rate their specialty highly in terms of pain management, they acknowledge treatment barriers to optimal care, and consider their training to be poor, according to a study published online Nov. 14 in the Journal of Clinical Oncology.

Brenda Breuer, Ph.D., M.P.H., from the Beth Israel Medical Center in New York City, and colleagues evaluated the attitudes, knowledge, and practices of U.S. medical oncologists related to cancer pain management. An anonymous survey was mailed to a geographically representative sample of 2,000 oncologists. The overall response rate was 32 percent.

The investigators found that the oncologists gave high ratings to their own specialty for its ability to manage cancer pain, but gave lower rating to their peers (median 7 and 3, respectively, on a scale of 0 to 10). They qualitatively rated the pain management training during medical school and residency as 3 and 5, respectively. Patient's reluctance to take opioids or report pain, and poor assessment were the most important barriers to pain management. Physician's reluctance to prescribe opioids, and perceived excessive regulation were also reported as barriers to pain management. In two different challenging clinical scenarios, 60 and 87 percent of oncologists, respectively, approved treatment decisions that pain specialists would consider to be unacceptable. Only 14 and 16 percent of oncologists reported frequent referrals to pain or palliative care specialists, respectively.

"A focus on cancer pain has not adequately addressed the perception of treatment barriers or limitations in pain-related knowledge and practice within the oncology community," the authors write.

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