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. 2024 Nov 20;32(12):811.
doi: 10.1007/s00520-024-08984-4.

Evaluating pain management practices for cancer patients among health professionals in cancer and supportive/palliative care units: a Belgian survey

Christel Fontaine  1 , Isabelle Libert  2 , Marie-Aline Echterbille  3 , Vincent Bonhomme  4 , Jacky Botterman  5 , Bram Bourgonjon  6 , Vincent Brouillard  7 , Yannick Courtin  8 , Joke De Buck  9 , Philip R Debruyne  10   11 , Martine Delaat  12 , Jean-Michel Delperdange  13 , Lionel Duck  14 , Els Everaert  15 , Caroline Lamot  15 , Stéphane Holbrechts  16 , Dominique Lossignol  16 , Francis Krekelbergh  17 , Christine Langenaeken  18 , Lore Lapeire  19 , Eline Naert  19 , Koen Lauwers  20 , Milica Matic  21 , Jeroen Mebis  22 , Geertje Miedema  23 , Michèle Pieterbourg  24 , Barbara Plehiers  25 , Kevin Punie  26 , Françoise Roblain  27 , Dirk Schrijvers  28 , Charles-Henri Serre  29 , Katherine Vandenborre  30 , Anne Vanden Broecke  30 , Heidi Van den Bulk  31 , Ludo Vanopdenbosch  32 , Florence Van Ryckeghem  33 , Jolanda Verheezen  34 , Vincent Verschaeve  35 , Mia Voordeckers  23 , Jean Klastersky  2
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Free article

Evaluating pain management practices for cancer patients among health professionals in cancer and supportive/palliative care units: a Belgian survey

Christel Fontaine et al. Support Care Cancer. .
Free article

Abstract

Background: Pain is reported in 66% of cancer patients with advanced disease. Adequate pain management is a cornerstone of comprehensive supportive cancer care.

Purpose: The purpose of this study was to assess pain management in Oncology Units in Belgium.

Methods: A descriptive research design was applied. A structured questionnaire developed by a writing committee was sent to 37 healthcare professionals in 2021. Twenty-four replied.

Results: In most centers, pain management is organized through the pain clinic (91.7%), followed by a multidisciplinary team (83.3%) and the palliative care unit (75%). Eighty-seven percent use tools to assess the pain, mostly for in-patients. Pain guidelines are applied in 17 centers with the ESMO guidelines being the most often mentioned. Mild to moderate pain is managed with paracetamol, non-steroidal anti-inflammatory drugs, and tramadol. All centers handle severe pain with strong opioids, including buprenorphine and fentanyl. Only 62% are concerned about the side effects of strong opioids. In case of neuropathic pain, treatments with pregabalin, gabapentine, and tricyclic antidepressants are the most common, followed by opioids and interventional therapies for refractory neuropathic pain. Asking advice to the pain clinic, combination therapy and opioid rotation are used for patients with inadequate analgesia. Eighty to 90% of the centers have access to intraspinal and epidural techniques, respectively. An active teaching program on pain relief is offered in 66%, but only 33% of the centers do active research focused on pain management.

Conclusions: This is the first survey on pain management in the Belgian centers. Surprisingly only one-third of the health professionals ask advice to the pain clinic in case of inadequate pain relief, meaning that we are far away from a multidisciplinary patient-centered approach. Therefore, the BSMO Supportive Care Task Force promotes the development of an interdisciplinary committee in every oncology unit.

Keywords: Active research; Assessment tools; Guidelines; Multidisciplinary patient-centered approach; Pain management.

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Conflict of interest statement

Declarations. Ethics approval: Not applicable. Competing interests: The authors declare no competing interests.

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