Peiyang Mao,1 Xin Tian,1 Yinxia Zhan,1 Feng Gao,2 Xiangyu Tan,1 Hongfan Yu,3 Xiaobo Du,2 Jie Li,2 Gang Feng,2 Jingyu Zhang,3 Qiuling Shi1– 3 

1School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Oncology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, People’s Republic of China; 3State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China

Correspondence: Qiuling Shi, School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China, Tel +861 829 058 5397, Email qshi@cqmu.edu.cn Jingyu Zhang, State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, People’s Republic of China, Tel +861 365 765 6552, Email 420581692@qq.com

Background: Pain is common among patients with malignant tumors. It significantly impacts quality of life, yet over 80% of advanced cancer patients lack adequate pain management. Despite improvements in China’s pain management program, challenges remain, especially for older adults and outpatient care.
Methods: We evaluated pain intensity management adequacy using a 0– 10 numerical rating scale (NRS), and Pain Management Index (PMI) at an outpatient oncology clinic. Differences and changes in pain levels were statistically analyzed using t-test, rank-sum, and chi-square tests. Factors associated with inadequate pain management were identified using multivariate logistic regression.
Results: Among 589 participants, 45.41% scored moderate to severe pain ≥ 4, and 81.32% experienced inadequate pain management (PMI < 0). Pain was more severe among older, than younger patients (4.15 ± 2.89 vs 3.65 ± 2.41, P < 0.001) and pain management was inadequate in older compared with younger patients (75.47% vs 89.87%). Undergoing targeted or immune adjuvant therapy (odds ratio [OR], 3.206; 95% confidence interval [CI], 1.538– 6.684) and poor physical status (OR, 5.053; 95% CI, 2.023– 12.622) emerged as significant risk factors for inadequate pain management.
Conclusion: Pain management is challenging for patients aged ≥ 60 years. Therefore, tailored interventions are needed to enhance care quality.
Plain Language Summary: Over 80% of advanced cancer patients lack adequate pain management, especially older adults. Tailored interventions are needed to improve care quality.

Keywords: cancer pain, pain management index, out-of-hospital pain management, older adult patients