Situation Analysis of Pain Management Practices in Bangladesh: Identifying Gaps and Challenges

Kazi Mahzabin Arin; Md Mostafa Kamal; Rijwan Bhuiyan; Chhamita Sultana Chhanda; Salma Azad Tanni; AKM Akhtaruzzaman

doi:10.62848/bjpain.v6i1.3919

Authors

Kazi Mahzabin Arin Assistant Professor and Advanced Clinical Fellow, Pain Medicine, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University. https://orcid.org/0009-0004-0064-3847
Md Mostafa Kamal Assistant Professor (OSD, DGHS) and Advanced Clinical Fellow, Pain Medicine, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University. https://orcid.org/0000-0002-4665-1904
Rijwan Bhuiyan Department of Noncommunicable Disease, Bangladesh University of Health Sciences. https://orcid.org/0000-0003-0005-8889
Chhamita Sultana Chhanda Assistant Professor (OSD, DGHS) and Advanced Clinical Fellow, Pain Medicine, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University. https://orcid.org/0009-0000-2274-0729
Salma Azad Tanni Classified Anaesthesiologist (CMH) and Advanced Clinical Fellow, Pain Medicine, Department of Anaesthesia, Analgesia and Intensive Care Medicine; Bangladesh Medical University. https://orcid.org/0009-0009-3858-3268
AKM Akhtaruzzaman Professor and Head, Division of Regional Anaesthesia and Pain Medicine, Department of Anaesthesia, Analgesia and Intensive Care Medicine; Bangladesh Medical University. https://orcid.org/0000-0002-2427-1863

DOI:

https://doi.org/10.62848/bjpain.v6i1.3919

Keywords:

Chronic pain, Pain Management, Pain Practice, Gaps and Challenges, LMIC, Bangladesh

Abstract

Background: Chronic pain is a global burden affecting over 30% of patients worldwide. The issue is particularly challenging in low- and middle-income countries, where there are limited dedicated pain services. In Bangladesh, national evidence on pain management practice and barriers to care is unexplored. Therefore, this study aimed to conduct a situational analysis of pain management practices among physicians in Bangladesh to identify gaps in training, resources, and multidisciplinary care, and to plan strategies to improve patient outcomes.

Methods: A cross-sectional study was conducted using an online survey. Physicians practicing pain management across Bangladesh were invited to participate. Data were collected regarding professional background, training in pain medicine, institutional capacity, use of pain assessment tools, treatment modalities, and barriers to pain management. Descriptive statistics were used for data analysis.

Results: Sixty-seven participants participated, predominantly anaesthesiologists (96.4%) practicing in an urban area (70.9%). 47.2% had no formal training in pain medicine, and 62.3% did not have training on Essential Pain Management (EPM). There are no dedicated pain management units in 60.4% of institutions. Application of standardized pain assessment tools remained variable. Pain management is largely medication-based (67.4%), with limited availability of multidisciplinary services (48.8%). Only 30.2% reported implementation of clinical practice guidelines. Key challenges included limited multidisciplinary support (66.7%), lack of training (56.4%), high treatment costs (38.5%), and poor patient adherence (41.0%).

Conclusion: This study identifies substantial gaps in current pain management practices in Bangladesh, including inadequate training, limited multidisciplinary care, and limited implementation of clinical practice guidelines. Addressing these challenges requires a coordinated national strategy focused on strengthening education and training, implementing clinical practice guidelines, and expanding multidisciplinary pain services.