Evidence-based practice beliefs and behaviors of nurses providing cancer pain management

2015 ◽  
Vol 19 (3) ◽  
pp. 325-326 ◽  
Author(s):  
Andreas Charalambous
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Cancer Pain Management ◽  
And Behaviors

scholarly journals Independent Research on Cancer Pain Management in the Setting of Early Palliative Care: A Flywheel to Counteract General Opioid Misuse and Abuse

2020 ◽  
Vol 17 (19) ◽  
pp. 7097
Author(s):  
Elena Bandieri ◽  
Leonardo Potenza ◽  
Fabio Efficace ◽  
Eduardo Bruera ◽  
Mario Luppi
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Cancer Pain ◽  
World Health ◽  
Evidence Based ◽  
Cancer Pain Management ◽  
Who Analgesic Ladder ◽  
Early Palliative Care ◽  
Positive Effects ◽  
Analgesic Ladder

The increased recognition of the high prevalence and important burden of cancer pain and the documentation of a large proportion of patients receiving inadequate analgesic treatment should have reinforced the need for evidence-based recommendations. The World health Organization (WHO) guidelines on cancer pain management—or palliative care—are traditionally based on a sequential, three-step, analgesic ladder according to pain intensity: nonopioids (paracetamol or nonsteroidal anti-inflammatory drugs) to mild pain in step I; weak opioids (eg, codeine or tramadol) to mild-moderate pain in step II; and strong opioids to moderate-severe pain in step. III. Despite the widespread use of this ladder, unrelieved pain continues to be a substantial concern in one third of patients with either solid or hematologic malignancies. The sequential WHO analgesic ladder, and in particular, the usefulness of step II opioids have been questioned but there are no universally used guidelines for the treatment of pain in patients with advanced cancer and not all guideline recommendations are evidence-based. The American Society of Clinical Oncology and the European Society of Medical Oncology have recommended the implementation of early palliative care (EPC), which is a novel model of care, consisting of delivering dedicated palliative service concurrent with active treatment as early as possible in the cancer disease trajectory. Improvement in cancer pain management is one of the several important positive effects following EPC interventions. Independent well-designed research studies on pharmacological interventions on cancer pain, especially in the EPC setting are warranted and may contribute to spur research initiatives to investigate the poorly addressed issues of pain management in non cancer patients.

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