Procedural pain in patients with cancer: a Delphi expert management consensus
| Autor: | Josep Porta-Sales, Rosa M Morera López, María Dolores López Alarcón, Francisco Villegas Estévez, Almudena Sanz-Yagüe, Carmen Beato |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Palliative care Oncology (nursing) business.industry Delphi method Medicine (miscellaneous) Cancer General Medicine medicine.disease Likert scale Fentanyl Procedural Pain 03 medical and health sciences Medical–Surgical Nursing 0302 clinical medicine Pain assessment 030220 oncology & carcinogenesis Physical therapy medicine 030212 general & internal medicine business computer Delphi computer.programming_language medicine.drug |
| Zdroj: | BMJ supportivepalliative care. |
| ISSN: | 2045-4368 |
| Popis: | ObjectivesDiagnosis, treatment and care of cancer often involve procedures that may be distressing and potentially painful for patients. The PROCEDIO Study aimed to generate expert-based recommendations on the management of moderate to severe procedural pain in inpatients and outpatients with cancer.MethodsUsing a two-round Delphi method, experts from pain and palliative care units, medical and radiation oncology and haematology departments expressed their agreement on 24 statements using a 9-point Likert scale, which were classified as appropriate (median 7–9), uncertain (4–6) or inappropriate (1–3). Consensus was achieved if at least two-thirds of the panel scored within the range containing the median.ResultsWith an overall agreement on the current definition of procedural pain, participants suggested a wider description based on evidence and their clinical experience. A strong consensus was achieved regarding the need for a comprehensive pre-procedural pain assessment and experts emphasised that healthcare professionals involved in procedural pain management should be adequately trained. Most panellists (98.2%) agreed that pharmacological treatment should be chosen considering the duration of the procedure. Transmucosal fentanyl (96.5%) and morphine (71.7%) were recommended as the most appropriate drugs. Oral and nasal transmucosal fentanyl were agreed as the most suitable for both outpatients and inpatients, while consensus was reached for intravenous and subcutaneous morphine for inpatients.ConclusionsThese results provide updated expert-based recommendations on the definition, prevention and treatment of moderate to severe procedural pain, which could inform specialists involved in pain management of patients with cancer. |
| Databáze: | OpenAIRE |
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