educational interventions including the use of protocols
patient related issues which may interfere with optimal pain management
difficulty in accepting their prognosis,
lack of knowledge regarding the various treatments for pain
a fear of those treatments and their adverse effects
Common issues with family and caregivers
a lack of understanding about analgesics
poor communication with palliative care providers.
Health system barriers to optimal pain management in palliative care
a lack of referral pathways
a lack of specialist services to refer to.
A systematic review of models of service delivery for cancer pain
ultidisciplinary pain consultation services, with referral via a clinical pathway
The prevalence of uncontrolled pain is an important quality indicator for health services, and validated quality indicators are available. [35-39] The use of pain as a quality indicator is complex as multiple assessment tools are used within individual patient and disease groups and some patient cohorts are underrepresented.