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Diagnosing Neuropathic Pain in Patients with Cancer: Comparative Analysis of Recommendations in National Guidelines from European Countries
Author(s) -
Piano Virginie,
Verhagen Stans,
Schalkwijk Annelies,
Burgers Jako,
Kress Hans,
Treede RolfDetlef,
Hekster Yechiel,
LanteriMinet Michel,
Engels Yvonne,
Vissers Kris
Publication year - 2013
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12018
Subject(s) - neuropathic pain , medicine , cancer pain , neuralgia , cancer , pain assessment , population , physical therapy , anesthesia , pain management , environmental health
Background Neuropathic pain is a prevalent symptom in patients with cancer, which needs a more specific algorithm than nociceptive pain or neuropathic pain from other origin. Clinical practice guidelines ( CPG s) can be helpful in optimizing the diagnosis of neuropathic pain in patients with cancer. Methods In this study, 9 national CPG s in Europe on the diagnosis of neuropathic pain in patients with cancer were included. Recommendations with their grade (according SIGN 55 classification) and supporting literature (first author, patients' population, year, and type of publication) were compared between CPG s. Results Nine CPG s including recommendations on neuropathic pain could be selected and were assessed. In total, they used 149 references of which 72 (48%) were about cancer conditions, 39 (26%) about neuropathic pain, and only 3 about neuropathic pain in patients with cancer (2%). Only 28 (19%) references were shared between 2 or more guidelines. There was only one shared reference specifically related to cancer neuropathic pain. Recommendations and their evidence grading strongly differ between CPG s. Conclusion This work demonstrates an important heterogeneity between European recommendations on diagnosis and assessment of neuropathic pain in patients with cancer. The main weaknesses are the low level of evidence and the absence of specific data focusing on neuropathic pain in patients with cancer. We recommend that physicians dealing with neuropathic pain in patients with cancer should be specially trained, that a specific methodology to develop CPG s should followed, and that specific research should be developed on the diagnosis of neuropathic pain in patients with cancer.