<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1885-642X</journal-id>
<journal-title><![CDATA[Pharmacy Practice (Granada)]]></journal-title>
<abbrev-journal-title><![CDATA[Pharmacy Pract (Granada)]]></abbrev-journal-title>
<issn>1885-642X</issn>
<publisher>
<publisher-name><![CDATA[Centro de Investigaciones y Publicaciones Farmacéuticas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1885-642X2019000100015</article-id>
<article-id pub-id-type="doi">10.18549/pharmpract.2019.1.1397</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Prevalence of pain and treatment outcomes among cancer patients in a Malaysian palliative care unit]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mejin]]></surname>
<given-names><![CDATA[Melissa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Keowmani]]></surname>
<given-names><![CDATA[Thamron]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abdul Rahman]]></surname>
<given-names><![CDATA[Syuhaidah]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Liew]]></surname>
<given-names><![CDATA[Jerry]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[Jacqueline]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chua]]></surname>
<given-names><![CDATA[Morna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Che Wan]]></surname>
<given-names><![CDATA[Ilmiyah]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Queen Elizabeth Hospital Department of Pharmacy ]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A02">
<institution><![CDATA[,Queen Elizabeth Hospital Department of Pharmacy Clinical Research Centre]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A03">
<institution><![CDATA[,Queen Elizabeth Hospital Palliative Care Unit ]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A04">
<institution><![CDATA[,Queen Elizabeth Hospital Department of Pharmacy ]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A05">
<institution><![CDATA[,Queen Elizabeth Hospital Department of Pharmacy ]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A06">
<institution><![CDATA[,Queen Elizabeth Hospital Palliative Care Unit Nursing Unit]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<aff id="A07">
<institution><![CDATA[,Queen Elizabeth Hospital Palliative Care Unit ]]></institution>
<addr-line><![CDATA[Kota Kinabalu Sabah]]></addr-line>
<country>Malaysia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>17</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1885-642X2019000100015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1885-642X2019000100015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1885-642X2019000100015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Pain remains one of the most common and debilitating symptoms of advanced cancer. To date, there is a lack of studies on pain and its treatment among Malaysian palliative care patients.  Objective: This study aimed to explore the prevalence of pain and its treatment outcomes among adult cancer patients admitted to a palliative care unit in Sabah, Malaysia.  Methods: Of 327 patients screened (01/09/15-31/12/17), 151 patients with assessed self-reported pain scores based on the numerical rating scale of 0-10 (current, worst and least pain within the past 24 hours) upon admission (baseline), 24, 48 and 72 hours post-admission and discharge were included. Pain severity and pain score reductions were analysed among those who experienced pain upon admission or in the past 24 hours. Treatment adequacy was measured by the Pain Management Index (PMI) among discharged patients. The PMI was constructed upon worst scores categorised as 0 (no pain), 1 (1-4, mild pain), 2 (5-6, moderate pain), or 3 (7-10, severe pain) which is then subtracted from the most potent level of prescribed analgesic drug scored as 0 (no analgesia), 1 (non-opioid), 2 (weak opioid) or 3 (strong opioid). PMI&#8805;0 indicated adequate treatment.  Results: Upon admission, 61.1% [95%CI 0.54:0.69] of 151 patients presented with pain. Of 123 patients who experienced pain upon admission or in the past 24 hours, 82.1% had moderate to severe worst pain. Throughout patients&#8217; ward stay until discharge, there was an increased prescribing of analgesics and adjuvants compared to baseline, excluding weak opioids, with strong opioids as the mainstay treatment. For all pain score types (current, worst and least pain within the past 24 hours), means decreased at each time point (24, 48 and 72 hours post-admission and discharge) from baseline, with a significant decrease at 24 hours post-admission (p&lt;0.001). Upon discharge (n=100), treatment adequacy significantly improved (PMI&#8805;0 100% versus 68% upon admission, p&lt;0.001).  Conclusions: Accounting for pain&#8217;s dynamic nature, there was a high prevalence of pain among cancer patients in the palliative care unit. Continuous efforts incorporating comprehensive pain assessments, evidence-based treatments and patient education are necessary to provide adequate pain relief and end-of-life comfort care.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Pain]]></kwd>
<kwd lng="en"><![CDATA[Pain Management]]></kwd>
<kwd lng="en"><![CDATA[Pain Measurement]]></kwd>
<kwd lng="en"><![CDATA[Prevalence]]></kwd>
<kwd lng="en"><![CDATA[Palliative Care]]></kwd>
<kwd lng="en"><![CDATA[Terminal Care]]></kwd>
<kwd lng="en"><![CDATA[Treatment Outcome]]></kwd>
<kwd lng="en"><![CDATA[Analgesics]]></kwd>
<kwd lng="en"><![CDATA[Opioid]]></kwd>
<kwd lng="en"><![CDATA[Non-Narcotic]]></kwd>
<kwd lng="en"><![CDATA[Patient Reported Outcome Measures]]></kwd>
<kwd lng="en"><![CDATA[Malaysia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Update on Prevalence of Pain in Patients With Cancer: Systematic Review and Meta-Analysis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beuken-van Everdingen]]></surname>
<given-names><![CDATA[MH van den]]></given-names>
</name>
<name>
<surname><![CDATA[Hochstenbach]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Joosten]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Tjan-Heijnen]]></surname>
<given-names><![CDATA[VC]]></given-names>
</name>
<name>
<surname><![CDATA[Janssen]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2016</year>
<volume>51</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1070-90</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The prevalence and severity of pain in cancer]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Daut]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Cleeland]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
</person-group>
<source><![CDATA[Cancer]]></source>
<year>1982</year>
<volume>50</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1913-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Greco]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Roberto]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Corli]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Deandrea]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bandieri]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cavuto]]></surname>
</name>
<name>
<surname><![CDATA[Apolone]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[J Clin Oncol]]></source>
<year>2014</year>
<volume>32</volume>
<numero>36</numero>
<issue>36</issue>
<page-range>4149-54</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Pain and its treatment in outpatients with metastatic cancer]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cleeland]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Gonin]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hatfield]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Edmonson]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Blum]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Stewart]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Pandya]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<source><![CDATA[N Engl J Med]]></source>
<year>1994</year>
<volume>330</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>592-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Cancer Pain Relief: With a Guide to Opioid Availability]]></source>
<year>1996</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="">
<source><![CDATA[NCCN Clinical Practice in Oncology (NCCN Guidelines®) Palliative Care]]></source>
<year>2019</year>
<edition>Version 1</edition>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Improving cancer pain management in Malaysia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lim]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Oncology]]></source>
<year>2008</year>
<volume>74</volume>
<numero>Suppl 1</numero>
<issue>Suppl 1</issue>
<page-range>24-34</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A palliative care programme in Malaysia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oommen]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Indian J Palliat Care]]></source>
<year>2005</year>
<volume>11</volume>
<page-range>49-52</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Toxicity and response criteria of the Eastern Cooperative Oncology Group]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oken]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Creech]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Tormey]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Horton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[McFadden]]></surname>
<given-names><![CDATA[ET]]></given-names>
</name>
<name>
<surname><![CDATA[Carbone]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Clin Oncol]]></source>
<year>1982</year>
<volume>5</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>649-55</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[PQRST: A mnemonic to communicate a change in condition]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bates]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
<name>
<surname><![CDATA[Bates]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Northway]]></surname>
<given-names><![CDATA[DI]]></given-names>
</name>
</person-group>
<source><![CDATA[J Am Med Dir Assoc]]></source>
<year>2002</year>
<volume>3</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>23-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="">
<source><![CDATA[PQRST Pain Assessment Method]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="book">
<source><![CDATA[Clinical Practice Guidelines: Management of Cancer Pain Guideline Development Group]]></source>
<year>2010</year>
<publisher-name><![CDATA[Ministry of Health Malaysia]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Serlin]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Nakamura]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Edwards]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
<name>
<surname><![CDATA[Cleeland]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
</person-group>
<source><![CDATA[Pain]]></source>
<year>1995</year>
<volume>61</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>277-84</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Pain assessment: global use of the Brief Pain Inventory]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cleeland]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Acad Med Singapore]]></source>
<year>1994</year>
<volume>23</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>129-38</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="">
<source><![CDATA[NCCN Clinical Practice in Oncology (NCCN Guidelines®) Adult Cancer Pain]]></source>
<year>2017</year>
<edition>Version 2</edition>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Twycross]]></surname>
<given-names><![CDATA[Robert]]></given-names>
</name>
<name>
<surname><![CDATA[Wilcock]]></surname>
<given-names><![CDATA[Andrew]]></given-names>
</name>
<name>
<surname><![CDATA[Howard]]></surname>
<given-names><![CDATA[Paul]]></given-names>
</name>
</person-group>
<source><![CDATA[PCF5+ Palliative Care Formulary]]></source>
<year>2015</year>
<publisher-name><![CDATA[palliativedrugs.com Ltd]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prevalence of undertreatment in cancer pain. A review of published literature]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Deandrea]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Montanari]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Moja]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Apolone]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Oncol]]></source>
<year>2008</year>
<volume>19</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1985-91</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The relationships among pain, nonpain symptoms, and quality of life measures in older adults with cancer receiving hospice care]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Black]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Herr]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Fine]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sanders]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Bergen-Jackson]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Titler]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Forcucci]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Pain Med]]></source>
<year>2011</year>
<volume>12</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>880-9</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Changes in symptom intensity among cancer patients receiving outpatient palliative care]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kang]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Kwon]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Hui]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Yennurajalingam]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bruera]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2013</year>
<volume>46</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>652-60</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Miyashita]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Kang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Baik]]></surname>
<given-names><![CDATA[YJ]]></given-names>
</name>
<name>
<surname><![CDATA[Mo]]></surname>
<given-names><![CDATA[HN]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2011</year>
<volume>41</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>478-84</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Symptom distress in patients attending an outpatient palliative radiotherapy clinic]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bradley]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chow]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2005</year>
<volume>30</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>123-31</page-range></nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[An international survey of cancer pain characteristics and syndromes. IASP Task Force on Cancer Pain. International Association for the Study of Pain]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caraceni]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Portenoy]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
</person-group>
<source><![CDATA[Pain]]></source>
<year>1999</year>
<volume>82</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>263-74</page-range></nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cancer Pain Syndromes]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Portenoy]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Hematol Oncol Clin North Am]]></source>
<year>2018</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>371-86</page-range></nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The macroscopic appearance of computed tomography-guided needle biopsy specimens correlates with tumor metastasis in non-small cell lung cancer]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Toshiyuki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kimura]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Suzumura]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Yoshimoto]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Oka]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Yamamoto]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Matsuura]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Mitsuoka]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Asai]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Tochino]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yoshimura]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kawaguchi]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Kudoh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Matsuoka]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ohsawa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hirata]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Osaka City Med J]]></source>
<year>2015</year>
<volume>61</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>105-12</page-range></nlm-citation>
</ref>
<ref id="B25">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cancer pain with a neuropathic component: a cross-sectional study of its clinical characteristics, associated psychological distress, treatments, and predictors at referral to a cancer pain clinic]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reis-Pina]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Acharya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lawlor]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2018</year>
<volume>55</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>297-306</page-range></nlm-citation>
</ref>
<ref id="B26">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[WHO cancer pain relief programme]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stjernsward]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Cancer Surv]]></source>
<year>1988</year>
<volume>7</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>195-208</page-range></nlm-citation>
</ref>
<ref id="B27">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The World Health Organization Cancer Pain and Palliative Care Program. Past, present, and future]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stjernsward]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Colleau]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Ventafridda]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>1996</year>
<volume>12</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>65-72</page-range></nlm-citation>
</ref>
<ref id="B28">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Opioid and adjuvant analgesics: compared and contrasted]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[MI]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Brito-Dellan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Hosp Palliat Care]]></source>
<year>2011</year>
<volume>28</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>378-83</page-range></nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Opioid switching in cancer pain: From the beginning to nowadays]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mercadante]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bruera]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Crit Rev Oncol Hematol]]></source>
<year>2016</year>
<volume>99</volume>
<page-range>241-8</page-range></nlm-citation>
</ref>
<ref id="B30">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Pain control among cancer patients receiving strong opioids and their perspective towards opioids in a developing coiuntry with a diverse multicultural background]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[DZF]]></given-names>
</name>
<name>
<surname><![CDATA[Kiu]]></surname>
<given-names><![CDATA[DKF]]></given-names>
</name>
<name>
<surname><![CDATA[Voon]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Oncol]]></source>
<year>2018</year>
<volume>29</volume>
<numero>suppl 9</numero>
<issue>suppl 9</issue>
<page-range>439</page-range></nlm-citation>
</ref>
<ref id="B31">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The use of morphine to treat cancer-related pain: a synthesis of quantitative and qualitative research]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flemming]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[J Pain Symptom Manage]]></source>
<year>2010</year>
<volume>39</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>139-54</page-range></nlm-citation>
</ref>
<ref id="B32">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Cancer pain management education rectifies patients'misconceptions of cancer pain, reduces pain, and improves quality of life]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koh]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Keam]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hyun]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Ju Seo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Uk Park]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Oh]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
<name>
<surname><![CDATA[Ahn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Pain Med]]></source>
<year>2018</year>
<volume>19</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2546-55</page-range></nlm-citation>
</ref>
<ref id="B33">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Complex Cancer Pain Assessment]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fink]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Brant]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Hematol Oncol Clin North Am]]></source>
<year>2018</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>353-69</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
