Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
Rafael Lopez , Carlos Camps , Parham Khosravi-Shahi , Vicente Guillem , Alfredo Carrato , Jesus Garcia-Foncillas , Juan J. Cruz , Pedro Gascon , Antonio Anton , Eduardo Diaz-Rubio , Margarita Feyjoo , Enrique Aranda
Background: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for cancer patients, which remains undertreated and underdiagnosed. The Spanish Society for Medical Oncology (SEOM) developed a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. Methods: With the objective of evaluate compliance with SEOM’ guideline, Fundación ECO designed a survey to identify awareness, perceptions, implementation and gaps, among Spanish medical oncologists. Results: A total of 83 oncologists with a median experience of 13 years responded. Although 87% of oncologists considered their clinical practice complied with SEOM recommendations, there were discrepancies between what oncologists agreed to do versus how they do in clinical practice, as shown in the table. Main barriers identified in our study were time pressure together with vague statements in some recommendations, and the need to regularly update to reflect the most recent knowledge on therapeutic management. Conclusions: Nonetheless, this nationwide survey reflects that oncologist’s clinical practice is increasingly guided by GPC, and thus, the evaluation process is necessary, both to gauge the true application of the GPC by the professionals and to evaluate their impact on health care.
AGREEMENT with | ADHERENCE to |
---|---|
99% SEOM CPG provides the most recent evidence-based care recommendations | - 86.7% declare full compliance with SEOM CPG |
- 7.2% consider CPG recommendations inappropriate | |
100% The prescription of specific medication for BTcP | Core factors when prescribing analgesia for BTcP: fast onset, high potency and short duration of effect |
- 97.6% recorded efficacy | |
- 91.6 % recorded adverse effects | |
99% Fentanyl as first-choice drug for BTcP treatment | 85.7%- 95% prescribed fentanyl as first-choice |
100% The minimum information recommended to be gathered for the clinical history | Implementation in medical history: |
- 73.5% number of episodes | |
- 66.3% pain intensity | |
- 45.8% duration of episodes | |
- 30.1% time to highest-intensity peak | |
- 75.9% possible triggers | |
- 73.5% relief strategies | |
- 86.7% etiopathogenic mechanisms |
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