Larue F, Colleau S M, Brasseur L, Cleeland C S
Hôpital International Université de Paris, France.
BMJ. 1995 Apr 22;310(6986):1034-7. doi: 10.1136/bmj.310.6986.1034.
To describe the treatment of cancer pain in France and to evaluate the predictive factors for inadequate management.
Multicentre, representative cross sectional survey.
20 treatment centres, including cancer centres, university hospitals, state hospitals, private clinics, and one homecare setting (in which patients are supported at home).
605 patients with cancer.
Patients rated prevalence and severity of pain and functional impairment related to pain. Doctors reported patients' cancer characteristic, performance status, pain severity, and analgesic drugs ordered.
57% (340/601) of patients with cancer reported pain due to their disease, and, of those with pain, 69% (224/325) rated their worst pain at a level that impaired their ability to function. 30% (84/279) were reported as receiving no drugs for their pain. Of the 270 patients in pain for whom information on treatment was available 51% (137/270) were not receiving adequate pain relief, according to an index based on the World Health Organisation's guidelines. French doctors were found to underestimate the severity of their patients' pain. Younger patients, patients without metastatic disease, patients with a better performance status, and patients who rated their pain as more severe than their doctors did were at greater risk for undertreatment of their pain.
In the light of the high prevalence and the severity of pain among patients with cancer, the assessment and treatment of cancer pain in France remain inadequate, emphasising the need for changes in patient care.
描述法国癌症疼痛的治疗情况，并评估管理不足的预测因素。
多中心、代表性横断面调查。
20个治疗中心，包括癌症中心、大学医院、国立医院、私立诊所和一个家庭护理机构（为患者提供居家支持）。
605例癌症患者。
患者对疼痛的患病率、严重程度以及与疼痛相关的功能损害进行评分。医生报告患者的癌症特征、体能状态、疼痛严重程度以及所开具的镇痛药。
57%（340/601）的癌症患者报告因疾病而疼痛，在这些疼痛患者中，69%（224/325）将其最严重疼痛评为影响其功能的程度。据报告，30%（84/279）的患者未接受任何止痛药物治疗。根据基于世界卫生组织指南的一项指标，在有治疗信息的270例疼痛患者中，51%（137/270）未获得充分的疼痛缓解。发现法国医生低估了患者疼痛的严重程度。年轻患者、无转移性疾病的患者、体能状态较好的患者以及将自己的疼痛评为比医生评估更严重的患者，其疼痛治疗不足的风险更高。
鉴于癌症患者疼痛的高患病率和严重程度，法国癌症疼痛的评估和治疗仍然不足，这突出了改变患者护理的必要性。
