Bridging the Gap: Engagement With Behavioral Health for Pain Management Among Oncology Patients

Behavioral health (BH) interventions are evidence-based components of multimodal pain management but remain underused in oncology populations. Understanding patient awareness of and engagement with BH can inform efforts to improve integration of BH into cancer pain care.

To examine awareness of, current use of, willingness to use, and engagement with BH strategies among oncology patients with chronic pain and identify demographic and clinical factors associated with these BH factors.

A cross-sectional survey was conducted among 455 oncology outpatients with chronic pain at a comprehensive cancer center. Survey items included awareness and use of BH strategies, willingness to try BH if recommended, and a composite engagement score reflecting overall receptivity to behavioral health support. Multivariable logistic and linear regression analyses were performed to examine BH associations with demographic (age, sex, ethnicity, and insurance status) and clinical (psychiatric diagnosis history, pain severity, and opioid use) factors.

Only 17.6% of the participants were aware of BH strategies, and 4.0% reported current use, although 34.3% indicated willingness to try BH if recommended by a provider. Engagement with BH was greater among women and patients with a psychiatric diagnosis in the health history. Provider recommendation was strongly associated with willingness to try behavioral health (odds ratio, 2.53; P < .001).

BH remains underrecognized and underused as a treatment modality for pain, although patients expressed openness to it, especially when endorsed by clinicians. Our findings underscore the usefulness of opportunities for targeted education and for clinician engagement to expand and integrate BH access in pain and oncology settings.