Pain afflicts most cancer patients, mainly in the advanced and metastatic phase of the disease. Despite the existence of well-known, published guidelines for cancer pain management recommended by the World Health Organization (WHO) and the availability of effective treatments for 70-90% of cases, under-treatment is well documented and can involve up to 40% patients. Under-treatment is usually attributed to an incorrect use of opioids. In Italy, opioid consumption rates were among the lowest in Europe until 2000. A recent evaluation of the market sales shows an increase in opioid use (currently 45 DDD/100000), but there are data suggesting that it is mostly attributable to one drug, transdermal fentanyl. The fact that the sales and prescriptions of other opioids available to cancer patients in Italy (morphine and buprenorphine) remained constant suggests that some of the patients treated with fentanyl should have been treated with oral morphine, suggesting, in turn, that some of the prescriptions were inappropriate, at least according to the WHO recommendations. A project was launched by the Mario Negri Institute, in collaboration with representatives of the industry, scientific societies and patient associations, in order to increase the quality of pain management in cancer patients. The main objective of the project, which began in 2003, was to provide valid information about pain management in cancer for physicians, patients and families, and to increase the empiric evidence about the effectiveness of alternative opioid analgesic drugs. Two activities are under way, under the supervision of a multidisciplinary Advisory Board of experts: a. a critical appraisal of information available on the web with the preparation and publication of a meta-site to facilitate the use of selected resources by people interested and/or involved in issues related to cancer pain, b. a cohort study to assess the effectiveness of different analgesic strategies (such as the buprenorphine patch), with morphine (oral, sustained release) as the comparator drug. A randomized controlled trial will be implemented in addition to the cohort study, involving a large number of oncologists, palliativists and general practitioners.
|Translated title of the contribution||Pain in cancer patients: A research project|
|Number of pages||9|
|Journal||Ricerca e Pratica|
|Publication status||Published - Jul 2004|
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