Multidisciplinary management of persistent severe cancer pain: a collaborative European approach

Abstract

Cancer pain; Clinical practice; Delphi-like methodology

Dolor oncológico; Práctica clínica; Metodología Delphi

Dolor oncològic; Pràctica clínica; Metodologia Delphi

Purpose Cancer pain is often undertreated, with patients frequently referred late to specialist services. This study aimed to develop expert-led recommendations to address unmet needs in the management of persistent severe cancer pain in Europe. Methods An online questionnaire on cancer pain management was used to identify controversies in the clinical practice of European oncologists. A series of recommendations to address these controversies was then proposed and validated, using a Delphi-like methodology, by a joint expert panel of pain specialists and oncologists. Results Consensus was reached on 13 recommendations. Key agreements focused on the following: (i) collaboration: establishing cancer pain committees (87% agreement) and shared protocols (100%), (i) education: implementing telematic consultations (100%) and training sessions for oncologists (100%) and (iii) referral: establishing clear referral criteria (100%) for patients with poor quality of life (QoL) (100%) or persistent pain, regardless of aetiology (87–100%), to ensure timely access to specialist care. Conclusion Effective cancer pain management necessitates enhanced collaboration between specialties, targeted education for oncologists, and locally co-created protocols with clear referral criteria. These measures are essential to ensure that patients are referred to pain specialists in a timely and appropriate manner, which is crucial for improving their QoL.

This work was financially supported by ESTEVE and Medtronic. The founders provided logistical support for the study, including the organization of meetings for the development of the survey and the European Meeting on Severe Cancer Pain Management, data interpretation, journal submission, and the medical writing services.