1st and largest multi-country study in Asia reveals patients require better specialist care and pharmacotherapy to treat the growing burden of pain

January 18, 2016 - 13 minutes read
  • New Mundipharma Asia study highlights current shortfalls in diagnosis and treatment of pain
  • ACHEON survey finds only 6% of patients suffering from Cancer Pain in Asia have been treated by pain specialists
  • ACHEON study finds current physician pain assessment procedure and training remains inadequate in Asia
  • 84% of physicians surveyed agreed that opioids should be the first line of therapy for cancer pain

SINGAPORE, 6 October 2014 – Results from the first and largest cross-sectional evaluation of physicians’ and patients’ perspectives on cancer and non-cancer pain management in 10 Asian countries have revealed the pressing need to improve pain diagnosis and management for patients in Asia.

Mundipharma, a multinational pharmaceutical leader in pain management, will present new data collected on physician and patient perception in its ACHEON study. Four posters, summarising data collected from 1158 physicians and 2495 patients across Asia in the Mundipharma-sponsored ACHEON1 study, will be presented at the International Association for the Study of Pain’s 15th World Congress on Pain in Buenos Aires, Argentina from 6-11 October 2014.

According to a 2009 World Health Organisation report, five billion people live in countries globally with low or no access to controlled medicines and have insufficient access to treatment for moderate to severe pain2. The ACHEON study has highlighted that barriers to optimising pain therapy are higher in Asian patients as compared to Western counterparts, raising concern over the shortfall in current treatment options and procedures3.

The ACHEON survey found that improving physicians’ education and clinical knowledge in pain assessment and opioid use would improve the consistency and accuracy of the pharmacotherapy used to treat the majority of chronic-pain sufferers whose quality of life is significantly affected by their condition.

463 of the physicians recruited in the ACHEON survey were involved in the management of cancer pain and 30% of these considered their medical school training on cancer pain management and opioid use to be inadequate, highlighting the need for better medical school training and continuing medical education (CME) opportunities on pain-related topics in Asia.

  • 84% of those physicians agreed that opioids should be the first line of therapy for cancer pain

1190 patients with Cancer Pain were assessed using measurements of activities of daily living, sleeping patterns, concentration and focus, overall quality of life (QoL), performance at work and employment status.

  • 70% claimed that their performance at work was impacted by pain
  • 42% had stopped work due to their cancer pain
  • 84% of patients had never been referred to a pain clinic
  • Less than half of the patients had had their pain assessed according to a scale and only 6% had been treated by pain specialists

These findings confirm the impact of pain as a significant socioeconomic burden in Asian patients and show the imperative need to improve current clinical practices via adequate pain assessment and optimisation of treatment.

Chronic non-cancer pain (CNCP) is a highly prevalent condition with incidence rates as high as 40 – 50% in older adults45 and the treatment of chronic pain is further complicated by the under-diagnosis and the complexity of patient modalities even in the most advanced nations. CNCP is a substantial cause of morbidity, globally.

695 physicians involved in the management of CNCP were evaluated in the ACHEON survey to establish their attitudes towards pain management and prescribing habits, particularly opioid prescriptions.

  • 71% of these reported that they had received less than ten hours of CME related to pain management in the last year
  • 32% considered their medical school training on opioid use to be inadequate

Opioid therapy has shown benefits in short-term trials in patients with osteoarthritis and neuropathic pain; however, clinical skills and adequate knowledge are warranted to maximise opioid effectiveness due to safety concerns678.

  • 64% of the physicians surveyed said that opioids were necessary for the treatment of CNCP

Furthermore, under-diagnosed and under-treated CNCP is highly prevalent in clinical practice. Analysis of a group of 1305 CNCP patients evaluated their current pain levels, type of pain, attitudes towards pain and levels of satisfaction with their treatment. Most patients included in the survey had moderate to severe CNCP for a median duration of 2 years that had a significant detrimental impact on the quality of life.

  • 65% of patients reported that no pain scale was used by their physicians to assess their pain, relying only on a subjective assessment
  • Despite the high intensity of pain reported, only 4% of patients receiving pharmacotherapy reported being prescribed opioids.


Hanlim Moon, Head of Medical Affairs Mundipharma, Asia Pacific, Latin America, Middle East and Africa, commented: “The results from the ACHEON study clearly demonstrate the need for improved pain management practices in Asia. By accessing feedback from patients and physicians in this first anonymous, unbiased survey we have been to identify the shortcomings in the way pain is currently treated. Based on the findings, we are able to adapt the way that we at Mundipharma can support our broad portfolio of pain medications with training and education, strengthening our patient-centric approach to pain management.”

Raman Singh, President, Asia Pacific, Latin America, Middle East, and Africa, commented:

“Pain, acute and chronic, is a hugely debilitating illness which affects a significant proportion of the population in Asia and the ACHEON survey results confirm our findings in relation to the large and growing need to improve the current practices of pain management.

“At Mundipharma we consider it our responsibility to ensure that physicians and patients get the best possible opportunity to treat pain with the best training, practices and medications. We are already proactively investing in the education of all stakeholders through a diverse information program, including our regional Pain Forums, Pain Focus website, an educational online portal for both healthcare professionals and patients, as well as our Pain Assessment via Pain Scale initiatives, and look forward to building upon our initiatives throughout Asia.”

For further information please contact:

Stephenie Vasko
Communications Director – Asia, Latin America & Middle East PH +65-6303-9732

The non-interventional, anonymous, non-biased ACHEON survey was the first and largest cross-sectional evaluation of physicians’ and patients’ perspectives on cancer and non-cancer pain management in 10 Asian countries (China, Hong Kong, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand and Vietnam).

About Mundipharma
The Mundipharma network of independent associated companies consists of privately owned companies and joint ventures covering the world’s pharmaceutical markets. These companies are committed to bringing to patients the benefits of pioneering treatment options in the core therapy areas of oncology, pain, respiratory and rheumatoid arthritis.  https://www.mundipharma.com.sg/

About Cancer Pain
Pain in cancer may arise from a tumor compressing or infiltrating tissue; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response. At any given time, about half of all patients with malignant cancer are experiencing pain, and two thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living.91011

About IASP
IASP is the leading professional forum for science, practice, and education in the field of pain, bringing together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide.

About the World Congress on Pain
The World Congress on Pain is the premier congress devoted to the research and treatment of pain with the purpose of: providing a state-of-the-art overview of a wide range of topics in the area of pain; offering practical reviews of current research and therapies; providing continuing education credits for clinicians; and allowing delegates to participate in formal and informal discussions with international experts on pain management and pain research.

Posters to be presented
Copies of the posters will be made available on request to Lois.Ward@mundipharma-rd.eu

PF470/PF470 Current Practices for Cancer Pain Management in Asia: a Physician’s Perspective
C. Kim et al. (2014)
Friday, October 10, 2014 9:30 – 10:30 AM

PF341/PF341 Current Practices of Chronic Non-cancer Pain Management: Physicians’ Perspectives from a Pan Asian Survey
W. Cheung et al. (2014)
Friday, October 10, 2014 3:15 – 4:15 PM

PF404/PF404 Patients’ Perspectives on the Current Status of Cancer Pain Management in Asia
M. Tho et al. (2014)
Friday, October 10, 2014 9:30 – 10:30 AM

PS109/PS109 Patients’ Perspectives on Chronic Non-cancer Pain Management in Asia
O. Salido et al. (2014)
Saturday, October 11, 2014 3:15 – 4:15 PM

  • World Health Organization Briefing Note — February 2009. Access to Controlled Medications Programme
  • Chen CH, Tang ST, Chen CH. Meta-analysis of cultural differences in Western and Asian patient-perceived barriers to managing cancer pain. Palliat Med 2012;26(3):206–21.
  • International Association for the Study of Pain. Unrelieved pain is a major global healthcare problem. http://www.efic.org/userfiles/Pain%20Global%20Healthcare%20Problem.pdf
  • Helme RD, Gibson SJ. The epidemiology of pain in elderly people. Clin Geriatr Med 2001;17:417–31.
  • Furlan AD, Sandoval JA, Mailis-Gagxon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ 2006;174(11):1589–94.
  • Avouac J, Gossec L, Dougados M. Efficacy and safety of opioids for osteoarthritis: A meta-analysis of randomized controlled trials. Osteoarthritis Cartilage 2007;15:957–965
  • Eisenberg E, McNichol ED, Carr DM. Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin. JAMA 2005;293:3043–3052.
  • Hanna, Magdi; Zylicz, Zbigniew (Ben), eds. (1 January 2013). Cancer Pain. Springer. pp. vii & 17. ISBN 978-0-85729-230-8.
  • Marcus DA. Epidemiology of cancer pain. Curr Pain Headache Rep. 2011;15(4):231–4. doi:10.1007/s11916-011-0208-0. PMID 21556709.
  • Sheinfeld Gorin S, Krebs P, Badr H, et al. (February 2012). “Meta-analysis of psychosocial interventions to reduce pain in patients with cancer”. J. Clin. Oncol. 30 (5): 539–47. doi:10.1200/JCO.2011.37.0437. PMID 22253460.