Pain management in cancer patients in the main hospitals in Mozambique

Background: Pain is the most feared and distressing symptom in palliative care. In advanced stages of cancer, its incidence is 70-80%. In Mozambique there is little published information concerning to the prevalence, intensity, and pain's management in cancer patients. Methods: A cross-sectional observational study was conducted between August 2018 and January 2019, in Mozambique's main hospitals, and in the only hospital with an isolated provision of palliative care service. The analyzed data included demographic data, pain intensity and its treatment. The Pain Management Index was used to calculate the adequacy of the analgesia. Results: A total of 294 patients were included. The mean patients' age was 46.1 years old. Concerning to pain, 83.7% of the patients had pain, most of them moderate to severe pain. The prevalence of pain was frequent in women mainly in cervical cancer (84.3%) and in men with Kaposi sarcoma (80%). The main analgesic used for severe pain was paracetamol, and it was used alone in 40.9% of the patients. Morphine was used in 8.1% and adjuvants less than 10%. Pain Management Index was negative for 68.7% of the sample, meaning an inadequate analgesia. Significant differences were found in Pain Management Index levels between hospitals. Conclusions: The prevalence of pain in the main health institutions in Mozambique is high. Paracetamol was the analgesic most used in severe pain. Further studies are needed to understand the main reasons of patients' suffering.