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• W2087820606 abstract "In this issue of the journal, an interesting multicenter Spanish study by Antón and colleagues on 525 cancer patients in pain shows that 33% of them is satisfied with their analgesic treatment, 23% is unsatisfied and 44% is neither satisfied nor dissatisfied (neutral). This is a quite balanced distribution, which shows that only one-third of the patients are clearly satisfied. Such a fact makes us ponder on the efficacy of pain treatments normally administered and the possibility of improving the outcome expected from an analgesic therapy. At least three types of domains seem to influence the patients’ level of satisfaction. Without a doubt, the first one is the pain intensity experienced by the patients, even if the study shows that this is not always the case: 38% of the unsatisfied patients report a worst pain during the last week less than 5 points [Visual Analogue Scale (VAS)] and a lightest pain less than 3 points, which is a pain intensity normally associated with a good level of satisfaction. On the contrary, in this case, it seems that even a low level of pain severity could not match the expectations of the patients, which means that other factors must come into play. In fact, the aptitude and the behaviour of physicians, in terms of attention to the ‘pain’ problem, and more generally their ability to build an empathic relationship with the patients, appear as strong facets related to patient satisfaction. In particular, the capacity to inform patients on the positive and negative effects expected from the drugs seems to be relevant. This aptitude is not very usual in medical practice, as confirmed in this and other studies. A recent international survey (Rozemblum et al., 2011) indicates that care providers need to identify patient expectations to achieve a high level of patient satisfaction. Overall, 88.8% of the 1004 clinicians participating in the questionnaire survey stated that their awareness regarding patient expectations was moderate to low. Nurses were more suitable than physicians to ask patients about their expectations (20.1% vs. 11.5%, p < 0.001) and only 19.6% of the participants stated that they have been adequately trained to do so. This study identifies a ‘blind spot’ in clinicians’ approach when attempting to identify and address patient expectations and improve patient satisfaction. The third group of factors influencing satisfaction is strictly linked with the patients’ thoughts and beliefs about the feasibility of an effective cancer pain control, the confidence in the received analgesics, the lack of fear of addiction and the propensity to take morphine-like drugs. We think that these factors are also related to the patient awareness about the nature and prognosis of neoplastic disease (which we know is not always fully understood) and they also depend on the information about the characteristics and features of the proposed analgesic therapy. A peculiar aspect emerging from the Anton et al. study concerns the tool(s) used for the analysis of patient satisfaction. Two case report forms have been used: one filled in by the oncologists and the other based on a self-administered questionnaire provided to patients. The information recorded consists of a heterogeneous set of data, either objective or subjective, coming from the evaluations of both clinicians and patients. This method is useful to identify which aspects are relevant in determining patient satisfaction, but does not allow to quantify the degree of satisfaction. The use of other types of tools, such as those based on numerical or verbal rating scales, offers a quantitative approach to the evaluation of satisfaction. The values drawn from this measure are complementary to the more frequently used outcome measures like pain intensity, pain intensity difference and pain relief. For this reason, several authors (Fischer et al., 1999; Farrar et al., 2000; Turk et al., 2003) recommend to assess an overall evaluation of the perception of efficacy of the analgesic treatment together with the patient satisfaction, so that it becomes possible to evaluate both the amount of change in pain experience and the relevance given to therapy effects. None. None declared. O. Corli, S. Deandrea Center for the Evaluation and Research on Pain (C.E.R.P.), Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via La Masa 19, 20156 Milano, Italy Tel.: +39 02 390154654; fax: +39 02 33200231. E-mail address: oscar.corli@marionegri.it" @default.
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• W2087820606 date "2012-01-16" @default.
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• W2087820606 title "The impact of analgesic treatment: the patient's perspective" @default.
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• W2087820606 doi "https://doi.org/10.1002/j.1532-2149.2011.00100.x" @default.
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