Factors influencing physician management of cancer pain

It has been asserted that pain due to cancer is not adequately managed, and that physician attitudes may contribute to poor management. Based on responses to questionnaire items assessing attitudes that have been identified as affecting the quality of pain management, two groups of physicians were identified using cluster analysis on selected questionnaire items, and the responses of the two clusters to questions concerning their approach toward pain management were compared. With reference to reported practice, Cluster I physicians (N = 19) were willing to prescribe more potent analgesics and to do so earlier in the course of the disease as compared to Cluster II (N = 72). Cluster I members reported using more modalities of pain therapy, and more often saw scheduled analgesics as appropriate for the management of cancer pain. Groups did not differ in composition of medical specialty, nor in number of cancer patients cared for. More "liberal" attitudes toward pain management were associated with younger age and with more experience in specialized oncology units.