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. 2022 Feb 25;10(3):441.
doi: 10.3390/healthcare10030441.

Strengths and Weaknesses of Cancer Pain Management in Italy: Findings from a Nationwide SIAARTI Survey

Marco Cascella  1 , Alessandro Vittori  2 , Emiliano Petrucci  3 , Franco Marinangeli  4 , Antonino Giarratano  5   6 , Cristina Cacciagrano  7 , Emiliano Simone Tizi  7 , Luca Miceli  8 , Silvia Natoli  9 , Arturo Cuomo  1
Affiliations

Strengths and Weaknesses of Cancer Pain Management in Italy: Findings from a Nationwide SIAARTI Survey

Marco Cascella et al. Healthcare (Basel). .

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.

Keywords: breakthrough cancer pain; cancer pain; chronic pain; neuropathic pain; opioid; pain management; survey.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Regional distribution of cancer pain therapists. The color intensity expresses the percentage of respondents of each region.
Figure 2
Figure 2
Opioid therapy in naïve patients. Abbreviation: IR, immediate-release.
Figure 3
Figure 3
Opioid regimen adopted for breakthrough cancer pain treatment.
Figure 4
Figure 4
Adherence to guidelines. Legend: NCCN, National Comprehensive Cancer Network; ESMO, European Society for Medical Oncology; AIOM, Italian Association of Oncologists; GL, guidelines.
Figure 5
Figure 5
Quality of life questionnaires. Legend: EORTC QLQ-C30, European Organization for Research and Treatment of Cancer QLQ-C30; ESAS, Edmonton Symptom Assessment System.
See this image and copyright information in PMC

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