Cancer Pain Guidelines evaluation stresses on safe opioid practice and patient feedback systems, claims study

Cancer pain is the most distressing symptom in a patient's life, with fear of unrelieved pain sometimes exceeding the patient's fear of death.

Recently published research paper evaluates the quality of cancer pain guidelines and examines the inclusion of safe opioid practice. It highlights the distressing nature of cancer pain and emphasizes the concept of 'total pain management' that incorporates various modalities and safe opioid practices to improve the quality of life for cancer patients. The paper discusses the global challenge of limited access to opioids for cancer pain management and the looming opioid crisis due to misuse and abuse. It emphasizes the need for individualized protocols for different types of cancer pain and the importance of addressing end-of-life care pain management. The methodology involves evaluating the guidelines using the AGREE II and ADAPTE tools, and the primary outcome is to assess the quality of cancer pain guidelines. The review included 14 guidelines, and quality assessment was based on various domains such as rigour of development, applicability, and editorial independence. The study demonstrates good inter-rater reliability and identifies eight high-quality guidelines, with four specific guidelines deemed to be of the highest quality. The comprehensive assessment of the guidelines indicates that safe opioid practices and patient feedback are incorporated into the guidelines, contributing to their quality attributes. Overall, the paper provides a detailed evaluation of cancer pain guidelines and emphasizes the importance of safe opioid practices in cancer pain management.

Researchers  concluded that combined AGREE II and ADAPTE identified eight quality guidelines for quality evaluation, of which four cancer pain guidelines (MOHM, NCCN, NCEC-NCG, and WHO) were evaluated to be of the highest quality. All the evaluated guidelines inherently incorporated safe opioid practice and patient feedback systems, which are quality attributes.

Reference –

Thota, Raghu S.; Ramkiran, Seshadri1; Singh, Sarita2; Damani, Anuja3; Wajekar, Anjana S.4; Koyyalagunta, Lakshmi5. A systematic review and quality analysis of cancer pain guidelines. Indian Journal of Anaesthesia 67(12):p 1051-1060, December 2023. | DOI: 10.4103/ija.ija_325_23