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  • Title: Cancer pain management in prisons: a survey of primary care practitioners and inmates.
    Author: Lin JT, Mathew P.
    Journal: J Pain Symptom Manage; 2005 May; 29(5):466-73. PubMed ID: 15904749.
    Abstract:
    Cancer pain management among prison inmates is an emerging problem. To examine the obstacles to cancer pain management in inmates, surveys of inmates with cancer pain (IPs) (n = 102) and primary care practitioners (PCPs) (n = 74) in Texas state prisons were conducted. IPs were assessed using the Brief Pain Inventory and Pain Management Index (PMI). PCPs were assessed with a modified Clinic Staff Survey of Cancer Pain Management. Eighty-three IPs (81%) reported severe worst pain; 51 (49%) reported severe average pain. Thirty-three IPs (32%) reported no pain relief with prescribed analgesics. PMI was negative in 65 IPs (64%), indicating undertreatment. Of the PCPs, 20/65 (31%) felt that IPs were undertreated. Most frequently cited barriers to pain management were drug misuse/diversion and lack of inmate credibility. Practitioner problems and systemic barriers also were cited frequently. These results indicate the existence of unique barriers to undertreatment of cancer pain in IPs. A multidisciplinary approach involving prison authorities and practitioners is required to improve pain management in prison populations.
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