Abstract：
OBJECTIVE: Up to 40% patients with cancer reporting pain may not receive optimal analgesia indicating inadequate treatment of pain. We examined the patterns of outpatient pain management in patients with cancer who reported pain.
METHODS: We used the National Ambulatory Medical Care Survey data for outpatient visits from 2006 to 2018 for patients with any cancer and reporting pain. The primary outcome was prescription of pain medications among these patients. We performed multinomial logistic regression to identify factors associated with analgesic prescriptions among patients with cancer who reported pain.
RESULTS: We captured an estimated total of 412 million outpatient visits of which 22 million visits dealt with patients with cancer reporting pain. An estimated total of 13.8 million (61.33%) patient visits had pain reported but were not prescribed any pain medications. 5.5 million (24.44%) patient visits had non-opioid analgesic prescription while opioid analgesics were prescribed during 3.2 million (14.22%) visits. Patients who were black, aged 45-64 years, residing in rural geographical areas, visiting medical subspecialty practices, and having cancers of the respiratory and digestive systems had higher odds of receiving opioid prescription.
CONCLUSIONS: As one of the largest pain management studies among patients with cancer in the outpatient setting, covering 412 million patient visits, our study shows that a significant proportion of patients with cancer who reported pain did not receive a prescription for analgesics suggesting a possibility of undertreatment of pain.
CONCLUSIONS: Undertreatment of pain continues to remain a major unmet need in patients with cancer.
METHODS: We used the National Ambulatory Medical Care Survey data for outpatient visits from 2006 to 2018 for patients with any cancer and reporting pain. The primary outcome was prescription of pain medications among these patients. We performed multinomial logistic regression to identify factors associated with analgesic prescriptions among patients with cancer who reported pain.
RESULTS: We captured an estimated total of 412 million outpatient visits of which 22 million visits dealt with patients with cancer reporting pain. An estimated total of 13.8 million (61.33%) patient visits had pain reported but were not prescribed any pain medications. 5.5 million (24.44%) patient visits had non-opioid analgesic prescription while opioid analgesics were prescribed during 3.2 million (14.22%) visits. Patients who were black, aged 45-64 years, residing in rural geographical areas, visiting medical subspecialty practices, and having cancers of the respiratory and digestive systems had higher odds of receiving opioid prescription.
CONCLUSIONS: As one of the largest pain management studies among patients with cancer in the outpatient setting, covering 412 million patient visits, our study shows that a significant proportion of patients with cancer who reported pain did not receive a prescription for analgesics suggesting a possibility of undertreatment of pain.
CONCLUSIONS: Undertreatment of pain continues to remain a major unmet need in patients with cancer.
摘要：
目的：高达40%的报告疼痛的癌症患者可能未接受最佳镇痛，表明疼痛治疗不充分。我们检查了报告疼痛的癌症患者的门诊疼痛管理模式。
方法：我们使用了2006年至2018年全国门诊医疗护理调查数据，用于任何癌症和报告疼痛的患者的门诊就诊。主要结果是这些患者的止痛药处方。我们进行了多项逻辑回归，以确定报告疼痛的癌症患者中与镇痛处方相关的因素。
结果：我们估计总共有4.12亿次门诊就诊，其中2200万次就诊涉及癌症患者报告疼痛。估计总共有1380万（61.33％）的患者就诊报告了疼痛，但没有开任何止痛药。550万（24.44％）的患者就诊了非阿片类镇痛药处方，而在320万（14.22％）的就诊中处方了阿片类镇痛药。黑人患者，45-64岁,居住在农村地区，参观医学专科实践，患有呼吸系统和消化系统癌症的患者接受阿片类药物处方的几率更高。
结论：作为门诊癌症患者中最大的疼痛管理研究之一，涵盖4.12亿患者就诊，我们的研究表明,在报告疼痛的癌症患者中,有相当比例的患者未接受镇痛药处方,提示疼痛治疗不足的可能性.
结论：疼痛治疗不足仍然是癌症患者未满足的主要需求。
方法：我们使用了2006年至2018年全国门诊医疗护理调查数据，用于任何癌症和报告疼痛的患者的门诊就诊。主要结果是这些患者的止痛药处方。我们进行了多项逻辑回归，以确定报告疼痛的癌症患者中与镇痛处方相关的因素。
结果：我们估计总共有4.12亿次门诊就诊，其中2200万次就诊涉及癌症患者报告疼痛。估计总共有1380万（61.33％）的患者就诊报告了疼痛，但没有开任何止痛药。550万（24.44％）的患者就诊了非阿片类镇痛药处方，而在320万（14.22％）的就诊中处方了阿片类镇痛药。黑人患者，45-64岁,居住在农村地区，参观医学专科实践，患有呼吸系统和消化系统癌症的患者接受阿片类药物处方的几率更高。
结论：作为门诊癌症患者中最大的疼痛管理研究之一，涵盖4.12亿患者就诊，我们的研究表明,在报告疼痛的癌症患者中,有相当比例的患者未接受镇痛药处方,提示疼痛治疗不足的可能性.
结论：疼痛治疗不足仍然是癌症患者未满足的主要需求。
