633: Pain Management Practices in Bangladesh: A Situation Analysis for Improved Patient Outcomes

Topic: Education, Societal Impact, and Others
Subtopic: Organisation of clinical pain care

Background and Aims: Chronic pain is a major global health concern, affecting over 30% of the population worldwide and imposing substantial personal, social, and economic burdens1. The challenge is particularly pronounced in low- and middle-income countries (LMICs), where access to pain services, specialist training, and essential analgesics remains limited2,3. Low back pain is a leading cause of disability globally and contributes significantly to clinical and economic burden in LMICs4In Bangladesh, there is a significant gap in available information concerning pain management practices, institutional capabilities, and the challenges encountered in delivering effective care. This study aimed to conduct a situational analysis of pain management practices among physicians in Bangladesh, identifying gaps in training, resources, clinical protocols, and multidisciplinary care.

Methods: A cross-sectional study was conducted using an online survey administered via SurveyMonkey. Physicians involved in pain management across Bangladesh were invited through convenience sampling. The structured questionnaire collected data on professional background, training, institutional capacity, clinical practices, and perceived barriers. A total of 80 responses were received, with 52–64 complete responses depending on the variable. Data were analyzed using descriptive statistics. Participation was voluntary, and informed consent was obtained electronically.

Results: Most respondents were anaesthesiologists (95.31%) practicing predominantly in urban settings (70.31%). Nearly half (46.77%) had no formal training in pain medicine, and 61.29% had not attended Essential Pain Management (EPM) training. Dedicated pain management units were absent in 57.89% of institutions. While 66.67% reported using standardized pain assessment tools, consistent application remained variable, with reliance primarily on the Visual Analog Scale (66.67%). Pain management was predominantly medication-based (67.31%), with limited adoption of multidisciplinary approaches (44.23%). Institutional training programs were lacking in 69.23% of settings, and only 28.85% reported availability of clinical guidelines. Key challenges included limited training (59.57%), lack of multidisciplinary support (57.45%), high treatment costs (38.30%), poor patient adherence (38.30%), and staff shortages (42.55%). Notably, 92.31% of respondents reported difficulties in managing chronic pain.

Conclusions: This study highlights substantial gaps in pain management practices in Bangladesh, including inadequate training, limited multidisciplinary care, and insufficient adherence to standardized clinical guidelines. Although pain assessment tools are used, their inconsistent application reflects systemic constraints. Addressing these challenges requires a coordinated national strategy focused on strengthening education and training, expanding multidisciplinary services, and implementing evidence-based guidelines. Policy support, improved resource allocation, and integration of pain management into routine clinical care are essential to improve patient outcomes in Bangladesh and similar resource-limited settings.

References: 1. Goldberg DS, McGee SJ. Pain as a global public health priority. BMC Public Health. 2011;11:770.

2. International Association for the Study of Pain (IASP). Access to pain management in low- and middle-income countries.

3. Knaul FM, Farmer PE, Krakauer EL, et al. Alleviating the access abyss in palliative care and pain relief. Lancet. 2018;391(10128):1391–1454.

4. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–2367.

Presenting Author: Kazi Mahzabin Arin
Submitting Author: Kazi Mahzabin Arin

Senior Author: Professor AKM Akhtaruzzaman

IASP 2026 Global Year theme of Neuropathic Pain: No

• Professor AKM Akhtaruzzamn: MD - Bangladesh Medical University
• Md. Mostafa Kamal: MD - Bangladesh Medical University