Assessment of Pain by Brief Pain Inventory (BPI) and Analgesics Utilization Pattern in Cancer Patients Receiving Palliative Care: A Prospective Observational Study

Abstract

Background: Pain is a prevalent worry in advanced cancer, significantly impairing patients’ quality of life, functional ability, and emotional well-being during palliative care. Effective pain management, guided by the World Health Organization (WHO) analgesic ladder, is essential to alleviate suffering and improve clinical outcomes. Hence, the present study is planned to evaluate changes in pain severity and disruption of daily activities among cancer patients receiving supportive care. It also examined trends in the prescribing of analgesics according to the World Health Organization (WHO) analgesic guidelines.Materials and Methods: An observational study was conducted on 146 patients receiving palliative chemotherapy in a tertiary care hospital’s palliative unit from November 2023 to November 2024. Pain levels were assessed using the Brief Pain Inventory over two consecutive days. Analgesic prescriptions were recorded and analyzed for compliance with WHO pain ladder recommendations. Descriptive statistics and paired t-tests were used (p<0.05 considered significant).Results: Among 146 patients (77 females, 52.7%; 69 males, 47.3%), the mean age was 56.91±12.89 years. Maximum (p<0.001) and minimum (p=0.007) pain scores significantly decreased, with improved sleep quality (p=0.006). Commonly prescribed drugs included Gabapentin (26.36%), Paracetamol (24.85%), and Buprenorphine (20.3%). Opioids were frequently used for moderate (76.78%) and severe pain (54.54%), and non-opioids for mild pain (29.32%).Conclusion: Analgesic interventions effectively reduced pain and improved sleep, aligning with WHO guidelines. Multimodal strategies remain essential for addressing residual functional limitations.

Keywords: Brief Pain Inventory; Non-Opioid Analgesics; Opioid Analgesics; Palliative Care; WHO Analgesic Guidelines