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Minerva Anestesiologica 2010 October;76(10):833-43


language: English

Content development for EUROPEAN GUIDELINES on the use of opioids for cancer pain: a systematic review and Expert Consensus Study

Pigni A. 1, Brunelli C. 1, Gibbins J. 2, Hanks G. 2, Deconno F. 3, Kaasa S. 4, Klepstad P. 4, Radbruch L. 5, Caraceni A. 1

1 Palliative Care, Pain Therapy and Rehabilitation Department, IRCCS Foundation National Cancer Institute, Milan, Italy; 2 Department of Palliative Medicine, Bristol Hematology and Oncology Centre, University of Bristol, Bristol, UK; 3 Honorary Director of the European Association for Palliative Care (EAPC) and Honorary President of the Research Network of the European Association for Palliative Care, Milan, Italy; 4 Pain and Palliation Research Group, NTNU and Palliative Medicine Unit, Faculty of Medicine, Trondheim University Hospital, Trondheim, Norway; 5 Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany


Workpackage 3.1 (WP 3.1), within the European Palliative Research Collaborative (EPCRC), was aimed at critically revising and updating the European Association for Palliative Care recommendations on cancer pain management. The aim of this paper is to report the results of the first phase in the revision process which consists of a literature review and an expert consensus about the contents to be considered relevant in the development of the new guidelines. A systematic literature search was carried out from 2001 to 2008 through various databases including Medline, Cinahl, Cochrane Database of Systematic Reviews, Embase and Google. Through this process, guideline quality was evaluated, content was compared with EAPC recommendations and a first set of key-points was developed. A modified two-round Delphi method was applied to choose the most relevant topics for future systematic literature reviews. Fourteen guidelines on cancer pain management, published or updated after 2000, were retrieved. A comparison of these guidelines with the EAPC recommendations led to the formulation of 37 key-points, which were submitted to a panel of experts through a Delphi method. Through the responses given by the experts (25 after the first round and 19 after the second) and after a revision by the WP 3.1 local and steering committees, a final list of 22 topics was generated to answer all identified key-points. Each of these topics will be the object of systematic literature reviews. The final version of the “Evidence-based guidelines for the use of opioid analgesics in the treatment of cancer pain: the EAPC recommendations” will be based on the results of the 22 systematic literature reviews. (

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