Background: Cancer patients frequently receive inadequate pain relief. One potential explanation for treatment failure is that pain and other symptoms are not adequately assessed.
Methods: We included 201 cancer patients using morphine for pain control. We registered if and how pain and adverse symptoms were noted in the patient records at admission. The records were compared to patients' self-reports of pain.
Results: Notes on pain were taken for 90% of the patients. Physicians took notes on the presence of pain more often than nurses, but nurses used some form of systematic pain rating more frequently than did physicians. Bowel function was noted in 81%, sedation and nausea in about one third of the cases. Most patients for whom pain was not noted had low self-reported pain intensity.
Interpretation: Physicians and nurses assess pain in the majority of admissions of patients with cancer and ongoing treatment with morphine, but potential adverse effects are more infrequent addressed. Standardized and reproducible methods for assessing symptom intensity are seldom used. This study indicates that standardized note-taking of pain and other adverse symptoms should be included in cancer patients' admission records.