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      Standards for the management of cancer‐related pain across Europe—A position paper from the EFIC Task Force on Cancer Pain

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          Abstract

          Background and objective

          Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Evidence from meta‐analyses suggests that pain remains poorly controlled for a large proportion of patients; barriers to good management include poor assessment of pain, inadequate support for patient self‐management and late or inadequate access to strong opioid analgesia in those with advanced disease.

          Methods

          The European Pain Federation (EFIC) established a Task Force in 2017 which convened a European group of experts, drawn from a diverse range of relevant clinical disciplines, to prepare a position paper on appropriate standards for the management of cancer‐related pain. The expert panel reviewed the available literature and made recommendations using the GRADE system to combine quality of evidence with strength of recommendation. The panel took into account the desirable and undesirable effects of the management recommendation, including the cost and inconvenience of each when deciding the recommendation.

          Results and conclusions

          The 10 standards presented are aimed to improve cancer pain management and reduce variation in practice across Europe. The Task Force believes that adoption of these standards by all 37 countries will promote the quality of care of patients with cancer‐related pain and reduce unnecessary suffering.

          Significance

          Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control. These 10 standards are aimed to improve cancer pain management, promote the quality of care of patients and reduce variation across Europe.

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          Most cited references47

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          Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC.

          Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. The recommendations were developed by a writing committee that combined the evidence derived from the systematic reviews with the panellists' evaluations in a co-authored process, and were endorsed by the EAPC Board of Directors. The guidelines are presented as a list of 16 evidence-based recommendations developed according to the Grading of Recommendations Assessment, Development and Evaluation system. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Do we need a third mechanistic descriptor for chronic pain states?

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              Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline

              To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors.
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                Author and article information

                Contributors
                m.i.bennett@leeds.ac.uk
                Journal
                Eur J Pain
                Eur J Pain
                10.1002/(ISSN)1532-2149
                EJP
                European Journal of Pain (London, England)
                John Wiley and Sons Inc. (Hoboken )
                1090-3801
                1532-2149
                06 January 2019
                April 2019
                : 23
                : 4 ( doiID: 10.1002/ejp.2019.23.issue-4 )
                : 660-668
                Affiliations
                [ 1 ] St Gemma’s Academic Unit of Palliative Care University of Leeds Leeds UK
                [ 2 ] Pain Research Unit, Institute of Pain Medicine Rambam Health Care Campus and Technion, Israel Institute of Technology Haifa Israel
                [ 3 ] University of Sheffield Sheffield UK
                [ 4 ] Imperial College Healthcare NHS Trust London UK
                [ 5 ] Marymount University Hospital & Hospice Curraheen Ireland
                [ 6 ] Cork University Hospital Wilton Ireland
                [ 7 ] College of Medicine & Health University College Cork Cork Ireland
                [ 8 ] Pain Relief and Supportive Care La Maddalena Cancer Center Palermo Italy
                [ 9 ] Faculty of Medicine University of Maribor, Institute for Palliative Medicine and Care Slovenia
                [ 10 ] Department of Anesthesiology, Pain and Palliative Medicine Radboud University Medical Centre Nijmegen Netherlands
                [ 11 ] Centre for Pain Medicine, Department of Anesthesiology, Intensive Medicine, Pain/Palliative Medicine GFO‐Hospitals Bonn and University of Bonn
                [ 12 ] European Pain Federation Brussels Belgium
                [ 13 ] The Leuven Center for Algology and Pain Management University Hospitals Leuven KU Leuven Belgium
                Author notes
                [*] [* ] Correspondence

                Michael I. Bennett, St Gemma’s Academic Unit of Palliative Care, University of Leeds, Leeds, UK.

                Email: m.i.bennett@ 123456leeds.ac.uk

                [†]

                Joint first authors.

                Article
                EJP1346
                10.1002/ejp.1346
                7027571
                30480345
                610a19d7-e094-41c2-87ee-5b9549999efc
                © 2019 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 June 2018
                : 26 September 2018
                : 23 November 2018
                Page count
                Figures: 0, Tables: 3, Pages: 9, Words: 13963
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                April 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:18.02.2020

                Anesthesiology & Pain management
                Anesthesiology & Pain management

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