Assessment of Adherence to the WHO Pain Ladder in the Management of Cancer Pain at Hayatabad Medical Complex Peshawar
DOI:
https://doi.org/10.65761/pjcr.2026.308Keywords:
Cancer pain, WHO pain ladder, Analgesics, Opioids, Pain managementAbstract
Background: Cancer painis a common and distressing complication that can significantly impair patients’ quality of life. The World Health Organization (WHO) pain ladder provides a structured approach for selecting analgesic therapy according to pain severity. However, compliance with these recommendations may vary across healthcare settings. This clinical audit assessed compliance with the WHO pain ladder criteria in the management of cancer pain at Hayatabad Medical Complex,
Peshawar.
Methods: A hospital-based clinical audit was conducted among 120 adult cancer patients experiencing cancer-related pain. Data were collected through patient interviews and review of medical records using a structured proforma. Pain intensity was assessed using the Numerical Rating Scale (NRS). Prescribed analgesic regimens were compared with the predefined WHO pain-ladder criteria according to documented pain severity. Data were analyzed using SPSS, with
descriptive statistics and appropriate tests of association.
Results: Of the 120patients, 68 (56.7%) were males and 52 (43.3%) were females. Mild, moderate, and severe pain was reported by 18 (15.0%), 57 (47.5%), and 45 (37.5%) patients, respectively. Overall, 78 (65.0%) patients received analgesic management that met the predefined WHO pain-ladder criteria, while 42 (35.0%) did not meet the audit criteria. Compliance was highest among patients with mild pain (83.3%) and lower among those with moderate (63.2%) and severe pain
(60.0%).
Conclusion: Overall, 65.0% compliance with the predefined WHO pain-ladder criteria was observed. Improved pain assessment, appropriate analgesic selection, opioid availability, and healthcare-provider training are recommended.
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Copyright (c) 2026 Zubair Ahmad, Hamza Usman, Muhammad Adil, Mian Gul Muhammad Safyan, Adnan Afzal, Laraib Fatima, Gohar Seemab, Muhammad Shoaib, Sajid Nawaz
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