Evaluating pain management practices for cancer patients among health professionals: a global survey

On behalf of global collaborators, Michael Silbermann*, Maria Minerva Calimag, Elon Eisenberg, Boris Futerman, Paz Fernandez-Ortega, Amparo Oliver Germes, Juan P. Yaeger Monje, Ping Guo, Haris Charalambous, Sophia Nestoros, Ximena Pozo, Gouri Bhattacharyya, Glynis J. Katz, Paolo Tralongo, Daisuke Fujisawa, Gulnara Kunirova, Rehana Punjwani, Hani Ayyash, Ibtisam GhrayebNemeh Manasrah, Mary Jocelyn S Bautista, Aleksandra Kotinska-Lemieszek, Gustavo de Simone, Julie Cerutti, Nahla Gafe, Gulbeyaz Can, Fusun Terzioglu, Rejin Kebudi, Gonca Tuncel-Oguz, Ayfer Aydin, Gülçin Ozalp-Şenel, Amos Deogratius Mwaka, Alexey Youssef, Jeannine Brant, Gabriela Piriz Alvarez, John Weru, David Rudilla, Rasha Fahmi, Mohamed Hablas, Maryam Rassouli, Layth Mula-Hussain, Safa Faraj, Salma Al-Hadad, Mazin Al-Jadiry, Hasanein Ghali, Samaher A. Fadhil, Loai Abu-Sharour, Suha Omran, Mohammad Al-Qadire, Azza Hassan, Khaled Khader, Nesreen Alalf, Gamila Ahmed, Laura Galiana, Noemi Sansó, Akiko Abe, Gabriel Vidal-Blanco, Amparo Rochina

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries.

Objective: To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs.

Design: Descriptive survey.

Setting/Subjects: Fifty-six countries worldwide; convenience sample of 1639 consisted of 36.8% physicians; 45.1% nurses, and 4.5% pharmacists employed in varied settings.

Results: Improved pain management services are key elements. Top barriers include religion factors, lack of appropriate education and training at all levels, nonadherence to guidelines, patients' reluctance to report on pains, over regulation associated with prescribing and access to opioid analgesics, fear of addiction to opioids, and lack of discussions around prognosis and treatment planning.

Conclusion: The majority of patients with cancer in low-income countries are undertreated for their pain. Promoting cancer pain accredited program of training and education on pain management for physicians and nurses is crucial, as well as advocating policymakers and the public at large.
Original languageEnglish
Pages (from-to)1243-1248
Number of pages6
JournalJournal of Palliative Medicine
Issue number8
Early online date18 Apr 2022
Publication statusPublished - 27 Jul 2022

Bibliographical note

Funding Information:
The authors thank Professor Tomoko Majima, Chiba University, Chiba, Japan, for her ongoing advice and support, which helped design this global survey.

Publisher Copyright:
© Copyright 2022, Mary Ann Liebert, Inc.


  • cancer
  • global
  • management
  • opioids
  • pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Nursing(all)


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