Adequacy and patient satisfaction with pharmacological pain management at a cancer center in Rwanda: a cross-sectional study

Abstract

Cancer-related pain remains a major cause of suffering and impairs quality of life. Effective pharmacological control and patient satisfaction are key indicators of quality oncology care. In Rwanda, data on patient-reported outcomes of cancer pain management are limited. This study aimed to assess the adequacy of pharmacological cancer pain management and patient satisfaction at the Butaro Cancer Center of Excellence (BCCOE) and associated factors. An analytical cross-sectional study was conducted among 392 adult oncology inpatients receiving pharmacological pain management between February and July 2025. The Pain Management Index (PMI), which compares patients’ worst reported pain intensity with the most potent analgesic prescribed, was used to assess the adequacy of pain treatment. Patient satisfaction was measured using a modified Pain Treatment Satisfaction Scale (PTSS). Seven of the eight PTSS domains were used to classify patients as satisfied and dissatisfied. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to identify factors associated with treatment adequacy and satisfaction. Most participants were female (78.31%), aged 40 years and above (83%) and receiving chemotherapy (95.66%). Breast (48.72%) and cervical (11.20%) cancers were the most common diagnoses. Overall, 368 (93.90%) received adequate pain treatment. Weak opioids (49.74%) were the most prescribed analgesics. Regarding patient satisfaction, 71.32% ( n = 280) were classified as satisfied. Among the seven PTSS domains, “Information about pain and its treatment” received the lowest mean score (27.66%), indicating limited patient education. Patients with comorbidities and those diagnosed more than five years prior were significantly less likely to receive adequate pain control. Lower satisfaction was reported among patients younger than 40 years, males, individuals diagnosed within the past year, and those receiving multiple treatment modalities. Cancer pain management at BCCOE was generally adequate, with a high level of reported satisfaction. However, gaps remain in patient education regarding pain and its management. Patients with comorbidities and longer disease duration were less likely to receive adequate pain control, and satisfaction declined with participants receiving multiple treatment modalities. These findings highlight the need for individualized pain management and improved communication to address unmet formation needs.

The authors' abstract, as published at the source. BMC Palliative Care, 2026 · DOI ↗