<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902026000101204</article-id>
<article-id pub-id-type="doi">10.29193/rmu.42.1.5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Conocimiento y prescripción de opioides en dolor oncológico: encuesta a médicos residentes y posgrados en el Hospital Universitario]]></article-title>
<article-title xml:lang="en"><![CDATA[Knowledge and prescription of opioids in cancer pain: survey of resident and postgraduate physicians at the University Hospital]]></article-title>
<article-title xml:lang="pt"><![CDATA[Conhecimento e prescrição de opioides na dor oncológica: pesquisa com médicos residentes e pós-graduandos no Hospital Universitário]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bernardi-De-Vecchi]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pazos-Malcuori]]></surname>
<given-names><![CDATA[Gonzalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silveira-Masaguez]]></surname>
<given-names><![CDATA[Gonzalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica Clínica Médica B, Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad de Cuidados Paliativos, Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica Clínica Médica 1, Hospital Maciel, Administración de los Servicios de Salud del Estado]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>42</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902026000101204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902026000101204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902026000101204&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: a 40 años de la difusión de las pautas de la OMS para el control del dolor oncológico, este continúa siendo un desafío. Una encuesta realizada a médicos residentes en el año 2004 encontró carencias en el conocimiento de las pautas analgésicas y en la prescripción de morfina. La implementación del Plan Nacional de Cuidados Paliativos desde el 2013 ha llevado a la creación de unidades en hospitales públicos, principales lugares de formación de médicos residentes y posgrados. Actualizar el estado del arte sobre el nivel de capacitación en DO en médicos egresados en nuestro país es relevante.  Objetivos: describir el conocimiento de médicos residentes y posgrados en último año de formación en el tratamiento del dolor oncológico y conocer la prescripción de morfina en su práctica clínica.  Metodología: estudio descriptivo transversal, a médicos residentes y posgrados en el hospital universitario en su último trimestre. Se compararon resultados con encuesta del 2004. Se utilizó test de Chi cuadrado para comparación (nivel de significancia estadística p menor a 0,05).  Resultados: respondieron 82 encuestados, 69% especialidades médicas. El 96% refirió conocer la escalera analgésica de la OMS, el 79% reportó indicar analgesia reglada. El 74% reportó prescribir morfina. La causa más frecuente para su no prescripción fue no manejar el fármaco; de los no prescriptores, ninguno refirió por temor a la adicción.  Conclusiones: se consigna un aumento significativo del manejo del dolor por cáncer y de la prescripción de morfina. Consideramos que esta mejoría es multifactorial, derivada principalmente del fortalecimiento y creación de unidades en hospitales públicos a través de la implementación del Plan Nacional de Cuidados Paliativos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: forty years after the dissemination of the WHO guidelines for cancer pain management, it remains a challenge. A survey conducted among resident physicians in 2004 found gaps in knowledge of analgesic guidelines and in morphine prescribing. The implementation of the National Palliative Care Plan in 2013 led to the creation of units in public hospitals, the main training sites for resident and postgraduate physicians. Updating the state of the art regarding the level of training in cancer pain (CP) among physicians graduating in our country is relevant.  Objectives: to describe the knowledge of resident and postgraduate physicians in their final year of training regarding cancer pain management, and to assess morphine prescribing in their clinical practice.  Methodology: cross-sectional descriptive study of resident and postgraduate physicians at the university hospital in their final trimester. Results were compared with the 2004 survey. The chi-square test was used for comparisons (statistical significance set at p &lt; 0.05).  Results: eighty-two respondents completed the survey; 69% belonged to medical specialties. Ninety-six percent reported knowing the WHO analgesic ladder, and 79% reported prescribing scheduled analgesia. Seventy-four percent reported prescribing morphine. The most frequent reason for not prescribing it was not being familiar with the drug; among non-prescribers, none reported fear of addiction.  Conclusions: a significant increase in cancer pain management and morphine prescribing is reported. We consider that this improvement is multifactorial, mainly resulting from the strengthening and creation of units in public hospitals through the implementation of the National Palliative Care Plan.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: quarenta anos após a divulgação das diretrizes da OMS para o controle da dor oncológica, esta continua sendo um desafio. Uma pesquisa realizada com médicos residentes em 2004 encontrou deficiências no conhecimento das diretrizes analgésicas e na prescrição de morfina. A implementação do Plano Nacional de Cuidados Paliativos a partir de 2013 levou à criação de unidades em hospitais públicos, principais locais de formação de médicos residentes e pósgraduandos. Atualizar o estado da arte sobre o nível de capacitação em dor oncológica (DO) entre médicos recém-egressos em nosso país é relevante.  Objetivos: descrever o conhecimento de médicos residentes e pós-graduandos em seu último ano de formação sobre o tratamento da dor oncológica e avaliar a prescrição de morfina em sua prática clínica.  Metodologia: estudo descritivo transversal com médicos residentes e pós-graduandos do hospital universitário em seu último trimestre. Os resultados foram comparados com a pesquisa de 2004. Utilizou-se o teste do qui-quadrado para comparação (significância estatística estabelecida em p &lt; 0,05).  Resultados: oitenta e dois participantes responderam ao questionário; 69% eram de especialidades médicas. Noventa e seis por cento referiram conhecer a escada analgésica da OMS, e 79% relataram prescrever analgesia programada. Setenta e quatro por cento relataram prescrever morfina. O motivo mais frequente para não prescrevê-la foi não dominar o fármaco; entre os que não prescrevem, nenhum mencionou temor de dependência.  Conclusões: observa-se um aumento significativo no manejo da dor por câncer e na prescrição de morfina. Consideramos que essa melhora é multifatorial, resultando principalmente do fortalecimento e da criação de unidades em hospitais públicos por meio da implementação do Plano Nacional de Cuidados Paliativos.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dolor oncológico]]></kwd>
<kwd lng="es"><![CDATA[Prescripción de opioides]]></kwd>
<kwd lng="es"><![CDATA[Morfina]]></kwd>
<kwd lng="es"><![CDATA[Médicos residentes]]></kwd>
<kwd lng="en"><![CDATA[Cancer pain]]></kwd>
<kwd lng="en"><![CDATA[Opioid prescribing]]></kwd>
<kwd lng="en"><![CDATA[Morphine]]></kwd>
<kwd lng="en"><![CDATA[Resident physicians]]></kwd>
<kwd lng="pt"><![CDATA[Dor oncológica]]></kwd>
<kwd lng="pt"><![CDATA[Prescrição de opioides]]></kwd>
<kwd lng="pt"><![CDATA[Morfina]]></kwd>
<kwd lng="pt"><![CDATA[Médicos residentes]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stewart]]></surname>
<given-names><![CDATA[BW]]></given-names>
</name>
<name>
<surname><![CDATA[Wild]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<collab>International Agency for Research on Cancer, World Health Organization</collab>
<source><![CDATA[World cancer report 2014]]></source>
<year>2014</year>
<publisher-loc><![CDATA[Lyon ]]></publisher-loc>
<publisher-name><![CDATA[International Agency for Research on Cancer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2.</label><nlm-citation citation-type="">
<collab>Registro Nacional de Cáncer</collab>
<collab>Registro Nacional de Cáncer &#8211;Área Vigilancia Epidemiológica</collab>
<source><![CDATA[Área de Capacitación Técnico Profesional MF-BD 01/05. Comisión Contra el Cáncer 2019]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[van den Beuken-van Everdingen]]></surname>
<given-names><![CDATA[MHJ]]></given-names>
</name>
<name>
<surname><![CDATA[de Rijke]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Kessels]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
<name>
<surname><![CDATA[Schouten]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
<name>
<surname><![CDATA[Kleef]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Patijn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of pain in patients with cancer: a systematic review of the past 40 years]]></article-title>
<source><![CDATA[Ann Oncol]]></source>
<year>2007</year>
<volume>18</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1437-49</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Breivik]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cherny]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Collett]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[de Conno]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Filbet]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Foubert]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes]]></article-title>
<source><![CDATA[Ann Oncol]]></source>
<year>2009</year>
<volume>20</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1420-33</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Cancer pain relief]]></source>
<year>1986</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6.</label><nlm-citation citation-type="book">
<collab>Weltgesundheitsorganisation</collab>
<source><![CDATA[Cancer pain relief: with a guide to opioid availability]]></source>
<year>1996</year>
<edition>2nd ed.</edition>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zech]]></surname>
<given-names><![CDATA[DFJ]]></given-names>
</name>
<name>
<surname><![CDATA[Grond]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Lynch]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hertel]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Lehmann]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study]]></article-title>
<source><![CDATA[Pain]]></source>
<year>1995</year>
<volume>63</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>65-76</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ventafridda]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Tamburini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Caraceni]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[De Conno]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Naldi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A validation study of the WHO method for cancer pain relief]]></article-title>
<source><![CDATA[Cancer]]></source>
<year>1987</year>
<volume>59</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>850-6</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Von Roenn]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Cleeland]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Gonin]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hatfield]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Pandya]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>1993</year>
<volume>119</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>121-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Webster]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bremner]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Oosenbrug]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Durant]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[McCartney]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Katz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[From opiophobia to overprescribing: a critical scoping review of medical education training for chronic pain]]></article-title>
<source><![CDATA[Pain Med]]></source>
<year>2017</year>
<volume>18</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1467-75</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jacobsen]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Sjogren]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Møldrup]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Christrup]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Physician-related barriers to cancer pain management with opioid analgesics: a systematic review]]></article-title>
<source><![CDATA[J Opioid Manag]]></source>
<year>2007</year>
<volume>3</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>207-14</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Píriz Álvarez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Estragó]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Pattarino]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sandar]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dolor oncológico: un problema no resuelto]]></article-title>
<source><![CDATA[Rev Méd Urug]]></source>
<year>2004</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>32-43</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas-Bermúdez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo no adecuado del dolor por cáncer en Costa Rica: ¿un problema de formación académica?]]></article-title>
<source><![CDATA[Acta Méd Costarric]]></source>
<year>2014</year>
<volume>56</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>59-64</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Notejane]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Le Pera]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Bernadá]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Conocimientos relativos al abordaje del dolor en niños: encuesta a posgrados y residentes]]></article-title>
<source><![CDATA[Arch Pediatr Urug]]></source>
<year>2016</year>
<volume>87</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>323-31</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15.</label><nlm-citation citation-type="">
<collab>66° Aniversario del Hospital de Clínicas</collab>
<source><![CDATA[An Fac Med]]></source>
<year>2019</year>
<volume>6</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>84-123</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16.</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública</collab>
<source><![CDATA[Plan Nacional de Cuidados Paliativos]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17.</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública</collab>
<source><![CDATA[Encuesta anual sobre el desarrollo de los cuidados paliativos en Uruguay &#8212; análisis del año 2023]]></source>
<year>2024</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B18">
<label>18.</label><nlm-citation citation-type="book">
<collab>Universidad de la República. Facultad de Medicina, Escuela de Graduados</collab>
<source><![CDATA[Programa de formación de especialistas en Oncología Médica]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[UdelaR]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B19">
<label>19.</label><nlm-citation citation-type="book">
<collab>Universidad de la República. Facultad de Medicina, Escuela de Graduados</collab>
<source><![CDATA[Programa de formación de especialistas en Anestesiología]]></source>
<year>2002</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[UdelaR]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B20">
<label>20.</label><nlm-citation citation-type="book">
<collab>Universidad de la República. Facultad de Medicina, Escuela de Graduados</collab>
<source><![CDATA[Programa de formación de especialistas en Medicina Interna]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[UdelaR]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
