Abstract
Objectives: Despite guidelines, a large percentage of cancer patients continue to suffer from ineffectively treated pain. The authors undertook this survey to assess the strengths and weaknesses of cancer pain management in Italy. Design: This was a prospectively administered survey. Participants: The participants were anesthesiologists of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Intervention: A 58-item questionnaire covered the demographics and features of cancer pain management in the Italian context. Results: The authors received responses from 611 pain therapists of 279 centers. Only 22% of physicians are exclusively pain therapists. Seventy-five percent are specialists in anesthesiology, intensive care, and pain medicine. Most pain centers are hospital or university facilities (78%). The strengths of cancer pain management in Italy are the careful opioid prescriptions, the use of strategies for the treatment of neuropathic pain, patient/healthcare provider partnerships, and breakthrough cancer pain management. Weaknesses to be addressed include poor adherence to guidelines, inadequate attention toward the patient’s quality of life, insufficient use of minimally invasive techniques, lack of teamwork approaches, inappropriate timing of pain specialist engagement, and poor telemedicine use. Conclusions: Despite several strengths, further efforts are needed to improve the care of patients suffering from cancer pain in Italy.
Highlights
Licensee MDPI, Basel, Switzerland.Despite improvements in the understanding and treatment of cancer pain, and the many international and local guidelines developed on the topic [1,2,3,4], in a substantial percentage of patients, pain is not appropriately treated
Based on the analysis of the literature and from what was highlighted by recent guidelines on the topic, two subgroups of the SIAARTI study group for cancer pain independently formulated two series of “issues of concern” related to the inadequate pain management in cancer patients
SIAARTI reached and surveyed 279 centers that deal with cancer patients throughout Italy
Summary
Despite improvements in the understanding and treatment of cancer pain, and the many international and local guidelines developed on the topic [1,2,3,4], in a substantial percentage of patients, pain is not appropriately treated. An evidence-based medicine analysis calculated that approximately one-third of cancer patients had inadequately controlled pain, with low-quality control reaching nearly 70% of cases [5]. Since the stage of the disease is a significant variable, a meta-analysis found pain problems in about 66%. The authors did not observe substantial progress since their previous report in 2007 [7]. This severe gap reflects important clinical implications for patients and in healthcare [8]
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