Standards for the management of cancer-related pain across Europe-A position paper from the EFIC Task Force on Cancer Pain.


Journal

European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 20 06 2018
revised: 26 09 2018
accepted: 23 11 2018
pubmed: 28 11 2018
medline: 14 6 2019
entrez: 28 11 2018
Statut: ppublish

Résumé

Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Evidence from meta-analyses suggests that pain remains poorly controlled for a large proportion of patients; barriers to good management include poor assessment of pain, inadequate support for patient self-management and late or inadequate access to strong opioid analgesia in those with advanced disease. The European Pain Federation (EFIC) established a Task Force in 2017 which convened a European group of experts, drawn from a diverse range of relevant clinical disciplines, to prepare a position paper on appropriate standards for the management of cancer-related pain. The expert panel reviewed the available literature and made recommendations using the GRADE system to combine quality of evidence with strength of recommendation. The panel took into account the desirable and undesirable effects of the management recommendation, including the cost and inconvenience of each when deciding the recommendation. The 10 standards presented are aimed to improve cancer pain management and reduce variation in practice across Europe. The Task Force believes that adoption of these standards by all 37 countries will promote the quality of care of patients with cancer-related pain and reduce unnecessary suffering. Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control. These 10 standards are aimed to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Evidence from meta-analyses suggests that pain remains poorly controlled for a large proportion of patients; barriers to good management include poor assessment of pain, inadequate support for patient self-management and late or inadequate access to strong opioid analgesia in those with advanced disease.
METHODS METHODS
The European Pain Federation (EFIC) established a Task Force in 2017 which convened a European group of experts, drawn from a diverse range of relevant clinical disciplines, to prepare a position paper on appropriate standards for the management of cancer-related pain. The expert panel reviewed the available literature and made recommendations using the GRADE system to combine quality of evidence with strength of recommendation. The panel took into account the desirable and undesirable effects of the management recommendation, including the cost and inconvenience of each when deciding the recommendation.
RESULTS AND CONCLUSIONS CONCLUSIONS
The 10 standards presented are aimed to improve cancer pain management and reduce variation in practice across Europe. The Task Force believes that adoption of these standards by all 37 countries will promote the quality of care of patients with cancer-related pain and reduce unnecessary suffering.
SIGNIFICANCE CONCLUSIONS
Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control. These 10 standards are aimed to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.

Identifiants

pubmed: 30480345
doi: 10.1002/ejp.1346
pmc: PMC7027571
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Practice Guideline Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

660-668

Informations de copyright

© 2018 European Pain Federation - EFIC®.

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Auteurs

Michael I Bennett (MI)

St Gemma's Academic Unit of Palliative Care, University of Leeds, Leeds, UK.

Elon Eisenberg (E)

Pain Research Unit, Institute of Pain Medicine, Rambam Health Care Campus and Technion, Israel Institute of Technology, Haifa, Israel.

Sam H Ahmedzai (SH)

University of Sheffield, Sheffield, UK.

Arun Bhaskar (A)

Imperial College Healthcare NHS Trust, London, UK.

Tony O'Brien (T)

Marymount University Hospital & Hospice, Curraheen, Ireland.
Cork University Hospital, Wilton, Ireland.
College of Medicine & Health, University College Cork, Cork, Ireland.

Sebastiano Mercadante (S)

Pain Relief and Supportive Care, La Maddalena Cancer Center, Palermo, Italy.

Nevenka Krčevski Škvarč (N)

Faculty of Medicine, University of Maribor, Institute for Palliative Medicine and Care, Slovenia.

Kris Vissers (K)

Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, Netherlands.

Stefan Wirz (S)

Centre for Pain Medicine, Department of Anesthesiology, Intensive Medicine, Pain/Palliative Medicine, GFO-Hospitals Bonn and University of Bonn.

Chris Wells (C)

European Pain Federation, Brussels, Belgium.

Bart Morlion (B)

The Leuven Center for Algology and Pain Management, University Hospitals Leuven, KU Leuven, Belgium.

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