Title: Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer
Authors: GRECO Maria TeresaROBERTO AnnaCORLI OscarDEANDREA SILVIABANDIERI ElenaCAVUTO SilvioAPOLONE Giovanni
Citation: JOURNAL OF CLINICAL ONCOLOGY
Publisher: AMER SOC CLINICAL ONCOLOGY
Publication Year: 2014
JRC N°: JRC91198
ISSN: 0732-183X
URI: http://jco.ascopubs.org/content/32/36/4149
http://publications.jrc.ec.europa.eu/repository/handle/JRC91198
DOI: 10.1200/JCO.2014.56.0383
Type: Articles in periodicals and books
Abstract: Purpose: Pain is a frequent symptom in cancer patients with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, under-treatment is still very frequent. Materials and methods: We updated a systematic review published in 2008 which showed that, according to the Pain Management Index (PMI), 43.4% of cancer patients were under-treated. This review included observational and experimental studies reporting negative PMI for adults with cancer and pain published from 2007 to 2013 and retrieved through Medline, Embase and Google Scholar. In order to detect any temporal trend and identify potential determinants of under-treatment we compared papers published before and after 2007 with univariate, multivariate and sensitivity analyses. Results: In the new set of 20 papers published from 2007 to 2013 there was a decrease in undertreatment of about 25% (from 43.4 to 31.8%). In the whole sample the proportion of under-treated patients felt from 2007 to 2013, and an association was confirmed between negative PMI, economic level and non-specific setting for cancer pain. Sensitivity analysis confirmed the robustness of results. Conclusion: Analysis of 46 papers published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacological pain management has improved. However, about one third of patients still do not receive pain medication proportional to their pain intensity.
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