Cancer pain management: An Italian delphi survey from the rational use of analgesics (RUA) group

Background: In patients with cancer, the prevalence of pain is high, and pain management is often challenging despite the wide availability of drugs and guidelines. Methods: This Delphi survey was organized within the Rational Use of Analgesics (RUA) Group projects to reach a consensus among Italian palliative care specialists on pain assessment and management. Items were identified from recent publications on cancer pain and guidelines. Results: This survey included input from 190 palliative care specialists representing all Italian territory. A consensus was reached on 17 statements. Items concerning pain assessment achieved over 70% agreement amongst the participants. Items on principles of pain management and management according to type of pain, including breakthrough cancerrelated pain and neuropathic pain also achieved high levels of agreement. Conclusion: Results from the RUA project showed that Italian palliative care specialists had a particular interest in items related to pain challenges, in addition to the evaluation and control of pain associated with cancer. However, some discrepancies between current guidelines and clinical practice were observed.