Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study

Background: We aimed to gain insight into psychological barriers toward initiation of strong opioid analgesic use in patients with advanced recurrent cancer. Methods: This study included 46 patients who were prescribed with opioid analgesics for advanced recurrent cancer. The primary outcome was psy...

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Main Authors: Takehiko Tsuno, Takashi Kawaguchi, Ryota Yanaizumi, Junichi Kondo, Keiko Kojima, Takashi Igarashi, Masaki Inoue, Tomofumi Miura, Akime Miyasato, Kanako Azuma, Hiroshi Hamada, Tomoya Saeki, Hironori Mawatari, Hiroyuki Ogura, Akira Kotani, Takuhiro Yamaguchi, Hideki Hakamata
Format: Article
Language:English
Published: Mary Ann Liebert 2024-10-01
Series:Palliative Medicine Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/pmr.2023.0068
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author Takehiko Tsuno
Takashi Kawaguchi
Ryota Yanaizumi
Junichi Kondo
Keiko Kojima
Takashi Igarashi
Masaki Inoue
Tomofumi Miura
Akime Miyasato
Kanako Azuma
Hiroshi Hamada
Tomoya Saeki
Hironori Mawatari
Hiroyuki Ogura
Akira Kotani
Takuhiro Yamaguchi
Hideki Hakamata
author_facet Takehiko Tsuno
Takashi Kawaguchi
Ryota Yanaizumi
Junichi Kondo
Keiko Kojima
Takashi Igarashi
Masaki Inoue
Tomofumi Miura
Akime Miyasato
Kanako Azuma
Hiroshi Hamada
Tomoya Saeki
Hironori Mawatari
Hiroyuki Ogura
Akira Kotani
Takuhiro Yamaguchi
Hideki Hakamata
author_sort Takehiko Tsuno
collection DOAJ
description Background: We aimed to gain insight into psychological barriers toward initiation of strong opioid analgesic use in patients with advanced recurrent cancer. Methods: This study included 46 patients who were prescribed with opioid analgesics for advanced recurrent cancer. The primary outcome was psychological barriers assessed using the Japanese version of the Barriers Questionnaire-II (JBQ-II). The secondary outcomes were psychological changes and pain relief one week after the induction of strong opioid analgesics. Results: The mean age of participants was 63.6 years. Furthermore, 26.1% had an Eastern Cooperative Oncology Group (ECOG) performance status of ≥3. The mean JBQ-II total score was 1.97 (95% confidence interval: 1.75–2.19). At the initiation of opioid therapy, there was no difference in the total scores between the baseline and one week later. Nevertheless, there was a significant difference in the subscale “disease progression” score (mean 2.97 vs. 2.59, difference in means 0.38, standard error 0.16, p = 0.026). Personalized Pain Goal (PPG) was achieved in about half of the participants, and a trend toward a higher score in the subscale “harmful effects” (concern about adverse events) was observed in those who did not achieve PPG. Conclusion: This study showed that patients with advanced recurrent cancer have psychological barriers to opioid induction. The relationship between the presence of psychological barriers before and after induction of opioid analgesics and the speed of pain improvement was determined. The results may provide fundamental information for prospective intervention studies to develop individualized education programs for patients with psychological barriers to opioids. Clinical Trial Registration Number UMIN000042443.
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spelling doaj-art-7709fe79f77b4d228afe06529f12deb92025-08-20T03:49:37ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-0151435210.1089/pmr.2023.0068Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort StudyTakehiko Tsuno0Takashi Kawaguchi1Ryota Yanaizumi2Junichi Kondo3Keiko Kojima4Takashi Igarashi5Masaki Inoue6Tomofumi Miura7Akime Miyasato8Kanako Azuma9Hiroshi Hamada10Tomoya Saeki11Hironori Mawatari12Hiroyuki Ogura13Akira Kotani14Takuhiro Yamaguchi15Hideki Hakamata16Department of Pharmacy, Yokohama City University Medical Center, Yokohama, Japan.Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan.Department of Pharmacy, Yokohama City University Medical Center, Yokohama, Japan.Department of Palliative Medicine, Yokohama City University Medical Center, Yokohama, Japan.Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan.Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan.Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan.Department of Pharmacy and Yokohama Minami Kyousai Hospital, Yokohama, Japan.Department of Palliative and Supportive Care, Yokohama Minami Kyousai Hospital, Yokohama, Japan.Department of Pharmacy, Kameda Medical Center, Chiba, Japan.Department of Analytical Chemistry, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.Department of Analytical Chemistry, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.Background: We aimed to gain insight into psychological barriers toward initiation of strong opioid analgesic use in patients with advanced recurrent cancer. Methods: This study included 46 patients who were prescribed with opioid analgesics for advanced recurrent cancer. The primary outcome was psychological barriers assessed using the Japanese version of the Barriers Questionnaire-II (JBQ-II). The secondary outcomes were psychological changes and pain relief one week after the induction of strong opioid analgesics. Results: The mean age of participants was 63.6 years. Furthermore, 26.1% had an Eastern Cooperative Oncology Group (ECOG) performance status of ≥3. The mean JBQ-II total score was 1.97 (95% confidence interval: 1.75–2.19). At the initiation of opioid therapy, there was no difference in the total scores between the baseline and one week later. Nevertheless, there was a significant difference in the subscale “disease progression” score (mean 2.97 vs. 2.59, difference in means 0.38, standard error 0.16, p = 0.026). Personalized Pain Goal (PPG) was achieved in about half of the participants, and a trend toward a higher score in the subscale “harmful effects” (concern about adverse events) was observed in those who did not achieve PPG. Conclusion: This study showed that patients with advanced recurrent cancer have psychological barriers to opioid induction. The relationship between the presence of psychological barriers before and after induction of opioid analgesics and the speed of pain improvement was determined. The results may provide fundamental information for prospective intervention studies to develop individualized education programs for patients with psychological barriers to opioids. Clinical Trial Registration Number UMIN000042443.https://www.liebertpub.com/doi/10.1089/pmr.2023.0068cancer paindecision regretpsychological barriersstrong opioids
spellingShingle Takehiko Tsuno
Takashi Kawaguchi
Ryota Yanaizumi
Junichi Kondo
Keiko Kojima
Takashi Igarashi
Masaki Inoue
Tomofumi Miura
Akime Miyasato
Kanako Azuma
Hiroshi Hamada
Tomoya Saeki
Hironori Mawatari
Hiroyuki Ogura
Akira Kotani
Takuhiro Yamaguchi
Hideki Hakamata
Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
Palliative Medicine Reports
cancer pain
decision regret
psychological barriers
strong opioids
title Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
title_full Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
title_fullStr Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
title_full_unstemmed Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
title_short Psychological Barriers to the Use of Opioid Analgesics for Treating Pain in Patients With Advanced Recurrent Cancer: A Multicenter Cohort Study
title_sort psychological barriers to the use of opioid analgesics for treating pain in patients with advanced recurrent cancer a multicenter cohort study
topic cancer pain
decision regret
psychological barriers
strong opioids
url https://www.liebertpub.com/doi/10.1089/pmr.2023.0068
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