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

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.

Pain prevalence and pain management in children and adolescents in an italian third level pediatric hospital: a cross-sectional study

“…Opioid epidemics shifted attention to a problem that did not concern us, blocking a virtuous process that had seen an increase in the prescription of opioids in the right contexts. This has resulted in a retreat in the use and prescription of opioids, with unjustified alerts [35][36][37].…”

Considerations on the Obstacles That Lead to Slow Recruitment in a Pain Management Clinical Trial: Experiences from the Belgian PELICAN (PrEgabalin Lidocaine Capsaicin Neuropathic Pain) Pragmatic Study

“…Surveys have been performed in several countries to investigate some major pain-related issues [51][52][53][54]. In Italy, a nationwide survey was conducted to investigate the strengths and weaknesses of cancer pain management in the country [55]. Another survey investigated the state of pain in the elderly with dementia throughout Europe, hereby considering assessment, treatment guidelines as well as global policies for this specifc patient population [56].…”

Satisfaction with Telemedicine for Cancer Pain Management: A Model of Care and Cross-Sectional Patient Satisfaction Study

“…The need to carry out the first visit “preferably” in person is foreseen by the recent Italian legislation on telemedicine [ 3 ]. Nevertheless, in the absence of well-defined recommendations, we referred to our previous Delphi investigation [ 15 ] and to a recent nationwide survey on cancer pain management [ 16 ]. Notably, almost all the experts on the Delphi panel affirmed that, in such an important problem, preliminary face-to-face access should be required for clinical and regulatory purposes [ 15 ].…”

“…Notably, almost all the experts on the Delphi panel affirmed that, in such an important problem, preliminary face-to-face access should be required for clinical and regulatory purposes [ 15 ]. The same suggestion was collected in the subsequent survey [ 16 ]. This first face-to-face-visit step is also important for training, as patients and/or caregivers must be capable to use the telemedicine system.…”