Journal of Pain Research (Aug 2022)
A Delphi Study on the Management of Neuropathic Cancer Pain in Spain: The DOLNEO Study
Abstract
Concepción Pérez-Hernández,1 María Luz Cánovas,2 Alberto Carmona-Bayonas,3 Yolanda Escobar,4 César Margarit,5 Juan Francisco Mulero Cervantes,6 Teresa Quintanar,7 Ancor Serrano Alfonso,8 Juan Virizuela9 1Pain Unit, Hospital Universitario de la Princesa, Madrid, Spain; 2Anesthesia, Complexo Hospitalario Universitario de Ourense (SERGAS), Ourense, Spain; 3Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain; 4Medical Oncology, Hospital General Universitario Gregorio Marañon, Madrid, Spain; 5Pain Unit, Hospital General Universitario de Alicante, Alicante, Spain; 6Pain Unit, Hospital General Universitario Santa Lucía, Cartagena, Spain; 7Medical Oncology, Hospital General Universitario de Elche, Elche, Spain; 8Anesthesiology, Resuscitation and Pain Management, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain; 9Medical Oncology, Hospital Universitario Virgen Macarena, Sevilla, SpainCorrespondence: Concepción Pérez-Hernández, Pain Unit, Hospital Universitario de la Princesa, Calle de Diego de León 62, Madrid, 28006, Spain, Tel +34 915 20 22 00, Email [email protected]: The objectives of this project were to assess the current situation and management of cancer-related neuropathic pain (CRNP) in Spain and to provide specific recommendations for the assessment, diagnosis and treatment of CRNP using a Delphi methodology.Methods: This was a qualitative study that followed a Delphi methodology using a questionnaire with 56 statements that were grouped into 5 areas related to CRNP: prevalence and impact, pathophysiology, assessment and diagnosis, specific syndromes, treatment, and multidisciplinary approach. Based on the responses, the scientific committee prepared an algorithm and a recommended pathway for the management of CRNP.Results: Seventy-nine physicians attended the meeting and completed the questionnaire. Consensus was reached for all statements relating to the prevalence and impact of CRNP. However, the perceptions of specialists from palliative care of the frequency and impact of CRNP differed from those of other specialists. A high degree of consensus was reached for all statements concerning the assessment and diagnosis of CRNP. Regarding specific syndromes, the only statement with a lack of consensus was that on the frequency of NP in patients undergoing radiotherapy. There were some disagreements regarding the multidisciplinary approach and referral criteria for the management of NP.Conclusion: Our results show a large degree of agreement on the assessment, diagnosis and treatment of cancer-related neuropathic pain among the specialists involved in its management. There were, however, some disagreements regarding the multidisciplinary approach and referral criteria for the management of neuropathic pain.Keywords: cancer-related neuropathic pain, prevalence, diagnosis, treatment, consensus