Cancer Pain Management: An Italian Delphi Survey from the Rational Use of Analgesics (RUA) Group
Received 20 December 2019
Accepted for publication 16 April 2020
Published 8 May 2020 Volume 2020:13 Pages 979—986
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Michael A Überall
Giustino Varrassi,1 Franco De Conno,2 Luciano Orsi,3 Filomena Puntillo,4 Giovanni Sotgiu,5 John Zeppetella,6 Furio Zucco7
1Paolo Procacci Foundation, Rome, Italy; 2Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; 3SC Cure Palliative ASST Carlo Poma, Mantova, Italy; 4Anesthesia and Intensive Care Unit, Department of Emergency and Organ Transplants, University Hospital of Bari, Bari, Italy; 5Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; 6St Claire’s Hospice, Hastingwood, UK; 7Azienda Ospedaliera Salvini, Garbagnate Milanese, Italy
Correspondence: Giustino Varrassi
Paolo Procacci Foundation, Via Tacito 7, Rome 00193, Italy
Background: In patients with cancer, the prevalence of pain is high, and pain management is often challenging despite the wide availability of drugs and guidelines.
Methods: This Delphi survey was organized within the Rational Use of Analgesics (RUA) Group projects to reach a consensus among Italian palliative care specialists on pain assessment and management. Items were identified from recent publications on cancer pain and guidelines.
Results: This survey included input from 190 palliative care specialists representing all Italian territory. A consensus was reached on 17 statements. Items concerning pain assessment achieved over 70% agreement amongst the participants. Items on principles of pain management and management according to type of pain, including breakthrough cancer-related pain and neuropathic pain also achieved high levels of agreement.
Conclusion: Results from the RUA project showed that Italian palliative care specialists had a particular interest in items related to pain challenges, in addition to the evaluation and control of pain associated with cancer. However, some discrepancies between current guidelines and clinical practice were observed.
Keywords: cancer, pain, breakthrough cancer pain, neuropathic pain, Delphi survey
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