PAIN MANAGEMENT OF CANCER PATIENTS IN UNIVERSITY TEACHING HOSPITALS IN NIGERIA
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- NGN 5000
ABSTRACT
The number of cancer patients in the world is increasing. Of the estimated nine million new cases every year, more than half are in developing countries. The majority of these patients are incurable by the time their diseases are diagnosed. Approximately one third of the people who are actively receiving treatment for cancer and two thirds of those with advanced malignant diseases experience pain. Almost 75% of patients with advanced cancers that are admitted to the hospital report pain upon admission. This study was conducted to describe the pattern of cancer pain in patients, describe pattern of drug use and cost implication of cancer pain management and to describe the common types of cancer in patients attending the Oncology and Radiotherapy clinic of ABUTH. The study also investigated the knowledge of Health Care Professionals (Doctors, Nurses and Pharmacist) on the use of prescription pain medication. The study was a prospective and retrospective one, involving two hundred and sixty (260) patients attending the clinic at the Department of Oncology and Radiotherapy ABUTH, a visual analogue scale was used to measure pain before and during therapy. The study was conducted using a structured questionnaire and it had a scope of one year: (January to December 2005). Patients were interviewed in the Oncology clinic, the Radiotherapy room and the chemotherapy ward. Cervical and breast cancers are the most prevalent cancer types at the clinic. One hundred and seventy eight (79%) of the patients were married and 135 (82%) of the women are housewives. More than half do not have a family history of cancer, and about 64% of the patients have no any form of western education. vi The patients experiencing pain after initiation of therapy, 15% of them use Diclofenac for the relief of their pain. The most commonly used antineoplastic agents in the clinic were 5- flourouracil, doxorubucin hydrochloride and cyclophosphamide. Dexamathasone is the most frequent adjuvant drug used. Patients described their pain as being present every day, but the pain was not constant. Patients also communicated that the pain was present mostly at night but did not prevent them from sleeping. The patients also reported a remarkable decrease in the level of their pain, as most of them initially complained of severe pain, before the initiation of therapy and after the initiation of therapy, only mild pain was experienced. For patients whose records were seen (out of the 260), the total cost of managing cancer pain in the patients was approximately N16,347,125:00 (sixteen million three hundred and forty seven thousand one hundred and twenty five). This covers direct costs only, involving cost of laboratory investigations, surgery, radiotherapy, analgesics and chemotherapy.
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