Assessment of analgesics and alternative approaches in cancer pain management: A cross-sectional study

Abstract

Background

Pain is highly prevalent in cancer and requires proper assessment and management. The evaluation is important particularly in cancer pain management, to make some improvement in prescribing analgesics and alternative approaches in the hospitals to enhance the quality of life of cancer patients.

Objective

The objective of this study was to assess analgesics and alternative approaches in cancer pain management and compare current prescribing practices with WHO guidelines for pain management.

Methods

A cross-sectional study was conducted at PIMS, Islamabad. Data of 203 patients was analyzed. Patients’ age, gender, diagnoses, pain intensity, analgesics, and alternative approaches prescribed, were recorded. All these variables were summarized using descriptive statistics and comparison between variables done by using Chi-square test.

Result

Most patients were aged 26–35 years (29%), and 76% had blood cancer. Pain intensity was moderate in 51% of patients. Weak opioids (tramadol 69%, codeine + paracetamol 68%) were the most prescribed drugs. No strong opioids were used. Only 3% of patients received alternative therapies (physiotherapy, radiotherapy). About 54% of prescriptions were consistent with WHO pain management guidelines. The majority of pain management strategies did not align with WHO's analgesic ladder, particularly for severe pain cases, where strong opioids were noticeably absent. Significant associations were found between cancer stage, pain intensity, and type of analgesics used (p < 0.05).

Conclusion

This study found that the pain in cancer patients at PIMS is often undertreated, with a heavy reliance on weak opioids and low use of strong opioids and alternative therapies. Limited use of strong opioids reflects systemic barriers including restrictive regulations, high costs, and limited availability. Improved access to opioids, guideline-based prescribing, and integration of palliative care are essential to ensure effective pain relief for cancer patients in Pakistan.