Patient-Related Barriers to Chronic Pain Management Among Cancer Survivors: A Narrative Synthesis

TL;DR

This paper identifies patient-related barriers to managing chronic pain in cancer survivors, including communication issues, stigma around opioids, and negative perceptions of pain.

Contribution

The study provides a comprehensive synthesis of patient-related barriers to chronic pain management in cancer survivors, highlighting key areas for intervention.

Findings

Negative perceptions of chronic pain and poor patient-provider communication are major barriers.

Opioid-related stigma and side effects hinder effective pain management.

Symptom-related restrictions and logistical issues limit physical activity engagement.

Abstract

Purpose
: Cancer survivors often experience chronic pain, impacting their daily functioning and quality of life. Despite the existence of effective pain management therapies, cancer survivors may not experience adequate pain management related to patient-related barriers. This review aims to explore the patient-related barriers that inhibit effective chronic pain management among cancer survivors.
Methods
: A narrative synthesis was conducted using a systematic review of the literature. Abstract and full-text screening, along with quality appraisal and level of evidence assessments, were conducted. Data was extracted on each study’s approach, methods, results, and implications, and thematic analysis was used to synthesize the findings.
Results
: A total of 330 participants were included in the 11 papers reviewed. General barriers to chronic pain management included a lack of preparedness for chronic pain, negative perceptions toward chronic pain, and poor patient-provider communication. Opioid-specific barriers were identified and included opioid use disorder stigma, knowledge deficits about opioid-related terms, and undesirable side effects. Physical activity barriers included logistical considerations, symptom-related restrictions, and cognitive challenges.
Conclusions
: Patient-related barriers to chronic pain management among cancer survivors include general, opioid-related, and physical activity-related barriers. Among these, the most significant barriers were negative perceptions toward chronic pain, inadequate patient-provider communication, opioid-related stigma, undesirable side effects of opioids, and symptom-related barriers to physical activity.
Implications
: Healthcare providers, cancer survivors, and caregivers require more education on communication techniques, the biopsychosocial model of pain, and opioid use disorder. Social support interventions could also be developed to promote engagement in physical activity among cancer survivors.