Background & Aims
Pain is the most common complaint among cancer patients, impairing health-related quality of life (HRQOL). There is limited evidence on the characteristics of pain among cancer patients in Nepal with low-resource settings. The primary objective of this study was to assess pain characteristics among cancer patients and the association of QoL with sociodemographic, clinical and pain characteristics. The secondary objectives aimed to assess patients’ perceived barriers to pain management and medication adherence.
Methods
This multi-center study included adult patients (over 18 years old) with reported cancer diagnoses, and whoever experienced pain was included. Socio-demographic characteristics (e.g., age, gender, educational status), clinical characteristics (e.g. cancer diagnosis, staging), and pain characteristics (duration, type) were recorded. European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment Scale-revised (ESAS-r), Barriers Questionnaire II (BQ-II), Medication Adherence Rating Scale (MARS-5), as well as Hospital Anxiety and Depression Scale (HADS) were used to assess the outcomes.
Results
408 patients took part in the study. TMean age was 54.87 (15.65), and 59 patients (55.4%) were female. Common diagnoses included cervical (17.6%), lung (11.8%), and colorectal (12.0%) cancers. The reported pain duration was ? 3 months (44.4%), while the pain types varied, with 42.4% classified as nociceptive and 26.0% as neuropathic. HADS showed elevated anxiety scores (>7) in 57.6%, depression scores (>7) in 54.9% and total scores of >14 in 52.5% of patients. Various factors significantly predict Global Health Scale, including age (B:0.326, p=0.001), female (B:5.882, p=0.019), inpatient (B:-4.723, p= 0.04), having a postgraduate education (B:21.632, p=0.017), CCI (B:-1.79 decrease, p=0.133), specific cancer diagnoses, treatment types, KPS <50 (B:-8.978, p = 0.003), adverse drug reactions (B:-4.149, p<0.001), pain intensity (B:-1.788, p < 0.001) and metastasis (B:6.101, p=0.057). binary logistic regression analysis identified several significant predictors of medication adherence
Conclusions
In conclusion, our study highlights the multi-faceted nature of pain management and QoL for cancer patients in Nepal with low-resource settings. The findings highlight the significance of addressing various factors, including age, gender, education level, family status, hospital setting, and pain intensity, in developing comprehensive approaches to enhance patient well-being. Additionally, our research emphasizes the importance of tailored interventions targeting pain characteristics, patient barriers, and medication adherence to improve overall QoL. Implementing evidence-based pain management protocols informed by these findings can significantly enhance the care and well-being of cancer patients in Nepal. Additionally, recognizing the unique cultural and socio-demographic factors that may contribute to cancer pain in Nepal requires further investigation, offering valuable insights for similar contexts in LMICs.
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Presenting Author
Sunil Shrestha
Poster Authors
Sunil Shrestha
OTHR
Monash University Malaysia
Lead Author
Siew Li Teoh PhD
Monash University Malaysia
Lead Author
Shaun Lee
PhD
Monash University Malaysia
Lead Author
Vibhu Paudyal
Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham
Lead Author
Siew Hua Gan
Monash University
Lead Author
Simit Sapkota
MD
Kathmandu Cancer Center, Nepal
Lead Author
Bhuvan KC
PhD
Queensland University of Technology
Lead Author
Topics
- Assessment and Diagnosis