TY - JOUR T1 - Why are we not controlling cancer pain adequately in the community? JF - British Journal of General Practice JO - Br J Gen Pract SP - 438 LP - 439 DO - 10.3399/bjgp14X681229 VL - 64 IS - 626 AU - Rosalind Adam AU - Peter Murchie Y1 - 2014/09/01 UR - http://bjgp.org/content/64/626/438.abstract N2 - Poorly controlled cancer pain has recently received a considerable amount of negative media attention, partly as a result of the publication of a report by Marie Curie Cancer Care that is based on interviews with patients at end of life and with their carers.1 The report highlighted a number of unmet needs. Insufficient access to pain relief and delays in administering analgesia were expressed as particular concerns. Interviewees described carers ‘having to chase prescriptions’, and nurses waiting around at night for prescriptions to arrive. Concerns were raised about uncoordinated and discontinuous care, and a failure to implement appropriate anticipatory care. Out-of-hours (OOH) services were criticised for being inefficient and lacking empathy.In a supplementary Marie Curie-commissioned survey of 1000 UK GPs,2 61% of GPs believed that their terminally ill patients got inadequate access to care at night and at weekends, and six out of 10 GPs believed that the majority of their terminally ill patients’ pain was not completely relieved. The perceived reasons cited for inadequate pain relief included lack of anticipatory prescribing and poor availability of pain relief during the OOH period.There is good evidence that cancer pain control at the end of life is suboptimal in the community. The Office for National Statistics bereavement survey (VOICES) in 2012 sampled 49 207 recently bereaved informants.3 Relief of pain was reported as being provided ‘completely, all of the time’ most frequently in hospices … ER -