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The following is a summary of “Adherence to ESMO guidelines on cancer pain management and their applicability to specialist palliative care centers: An observational, prospective, and multicenter study,” published in the October 2024 issue of Pain by Carbonara et al. 

Pain management in patients with late-stage cancer has been piloted by the World Health Organization (WHO) guidelines, while the recent ESMO guidelines provide comprehensive recommendations for all stages of the illness.   

Researchers conducted a retrospective study to assess the appropriateness and applicability of ESMO guidelines (EGL) in patients with cancer admitted to palliative care.   

They performed a study on patients with advanced cancer in care centers. The 52 recommendations were grouped into 8 macro areas. Adherence levels were defined as percentages for each recommendation and categorized as high (>75%), medium (50%–75%), and low (<50%). If a recommendation was not followed, it was marked as “not applicable” (NA) or “not evaluable” (NE).   

The results showed that 35 recommendations from 476 patients were marked as NA or NE, primarily because their implementation took too long to achieve clinical results given the patients’ conditions. The opinions regarding drug selection were noted. By the end of the study, pain levels decreased from 5.0 to 2.6, patient satisfaction increased from 3.3 to 4.6, and QoL improved from 4.4 to 5.5.   

They concluded the palliative physicians exhibited a medium adherence to the EGL, emphasizing their applicability and clinical outcomes for far-advanced patients in palliative care. 

Source: onlinelibrary.wiley.com/doi/abs/10.1111/papr.13418