Annals of Oncology Advance Access originally published online on April 27, 2005
Annals of Oncology 2005 16(6):966-971; doi:10.1093/annonc/mdi180
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2005 European society of Medical Oncology
Predictors of prescription of morphine for severe cancer pain by physicians in Korea
1 Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi; 2 Department of Family Medicine, Seoul National University, Seoul; 3 Cancer Information Branch, Research Institute, National Cancer Center, Goyang, Gyeonggi; 4 Department of Internal Medicine, Seoul National University Hospital, Seoul; 5 Department of Internal Medicine, Kyunghee University Hospital, Seoul; 6 Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
* Correspondence to: Dr B. Y. Huh, Department of Family Medicine, Seoul National University Hospital, 28 Yungun-dong, Jongro-gu, Seoul, Korea. Tel: +82-2–760–3351; Email: bongyul{at}plaza.snu.ac.kr
Background:: This study was undertaken to identify predictors of the prescription of strong opioids, which are important for the management of severe cancer pain, by Korean physicians.
Methods:: A questionnaire based on a hypothetical case designed to assess the prescription of morphine by physicians was administered to 800 specialists in the Korea Cancer Association, of whom 147 (18.4%) responded, and to 2200 specialists in the Korean Academy of Family Medicine, of whom 388 (17.6%) responded. We used a multidimensional approach to identify the predictors of prescription of morphine by physicians.
Results:: In the hypothetical case scenario, only 16.5% of the respondents stated that they would prescribe morphine for severe cancer pain. Multiple logistic regression analysis showed that physicians with a positive attitude regarding opioid addiction [odds ratio (OR) 2.62; 95% confidence interval (CI) 1.54–4.46], experience of pain assessment (OR 2.09; 95% CI 1.13–3.87), recent residency training (OR 2.27; 95% CI 1.30–4.0) and positive self-evaluation as an oncology specialist (OR 2.60; 95% CI 1.41–4.78) were more likely to prescribe morphine. None of the 13 variables in the knowledge dimension significantly predicted prescription of morphine for severe cancer pain.
Conclusions:: The results of the survey suggest that we need to develop strategies to develop a positive attitude toward opioids, to increase experience in pain assessment and to improve cancer pain management training among Korean physicians.
Key words: cancer pain, morphine, physician, prescription