Active research; Assessment tools; Guidelines; Multidisciplinary patient-centered approach; Pain management; Analgesics; Analgesics, Opioid; Humans; Belgium; Surveys and Questionnaires; Neoplasms/complications; Practice Patterns, Physicians'/statistics & numerical data; Practice Patterns, Physicians'/standards; Health Personnel; Practice Guidelines as Topic; Pain Measurement/methods; Analgesics/therapeutic use; Analgesics/administration & dosage; Analgesics, Opioid/therapeutic use; Male; Palliative Care/methods; Pain Management/methods; Cancer Pain/therapy; Cancer Pain/drug therapy; Cancer Pain; Neoplasms; Pain Measurement; Palliative Care; Practice Patterns, Physicians'; Oncology
Abstract :
[en] [en] BACKGROUND: Pain is reported in 66% of cancer patients with advanced disease. Adequate pain management is a cornerstone of comprehensive supportive cancer care.
PURPOSE: The purpose of this study was to assess pain management in Oncology Units in Belgium.
METHODS: A descriptive research design was applied. A structured questionnaire developed by a writing committee was sent to 37 healthcare professionals in 2021. Twenty-four replied.
RESULTS: In most centers, pain management is organized through the pain clinic (91.7%), followed by a multidisciplinary team (83.3%) and the palliative care unit (75%). Eighty-seven percent use tools to assess the pain, mostly for in-patients. Pain guidelines are applied in 17 centers with the ESMO guidelines being the most often mentioned. Mild to moderate pain is managed with paracetamol, non-steroidal anti-inflammatory drugs, and tramadol. All centers handle severe pain with strong opioids, including buprenorphine and fentanyl. Only 62% are concerned about the side effects of strong opioids. In case of neuropathic pain, treatments with pregabalin, gabapentine, and tricyclic antidepressants are the most common, followed by opioids and interventional therapies for refractory neuropathic pain. Asking advice to the pain clinic, combination therapy and opioid rotation are used for patients with inadequate analgesia. Eighty to 90% of the centers have access to intraspinal and epidural techniques, respectively. An active teaching program on pain relief is offered in 66%, but only 33% of the centers do active research focused on pain management.
CONCLUSIONS: This is the first survey on pain management in the Belgian centers. Surprisingly only one-third of the health professionals ask advice to the pain clinic in case of inadequate pain relief, meaning that we are far away from a multidisciplinary patient-centered approach. Therefore, the BSMO Supportive Care Task Force promotes the development of an interdisciplinary committee in every oncology unit.
Libert, Isabelle; Department of Medical Oncology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
Echterbille, Marie-Aline; Medical Direction, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
Bonhomme, Vincent ; Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation
Botterman, Jacky; Department of Radiotherapy, AZ Sint-Lucas Gent, Ghent, Belgium
Bourgonjon, Bram; Department of Anesthesiology, Ziekenhuis Aan de Stroom Antwerpen, Antwerp, Belgium
Brouillard, Vincent; Department of Anesthesiology, CHwapi Tournai, Tournai, Belgium
Courtin, Yannick; Department of Palliative Care, Grand Hôpital de Charleroi, Charleroi, Belgium
De Buck, Joke; Department of Anesthesiology and Algology, Ziekenhuis Aan de Stroom Antwerpen, Antwerp, Belgium
Debruyne, Philip R; Department of Medical Oncology, Kortrijk Cancer Centre AZ Groeninge, Kortrijk, Belgium ; Medical Technology Research Centre, Anglia Ruskin University, Cambridge, UK
Delaat, Martine; Department of Palliative Care, UZ Gent, Ghent, Belgium
Delperdange, Jean-Michel; Department of Palliative Care, CHwapi Tournai, Tournai, Belgium
Duck, Lionel; Department of Medical Oncology, Cliniques Saint-Pierre Ottignies, Ottignies, Belgium
Everaert, Els; Department of Medical Oncology, VITAZ, Sint-Niklaas, Belgium
Lamot, Caroline; Department of Medical Oncology, VITAZ, Sint-Niklaas, Belgium
Holbrechts, Stéphane; Department of Medical Oncology, CHU Ambroise Paré Mons, Mons, Belgium
Lossignol, Dominique; Department of Medical Oncology, CHU Ambroise Paré Mons, Mons, Belgium
Krekelbergh, Francis; Department of Palliative Care, Heilig Hartziekenhuis Lier, Lier, Belgium
Langenaeken, Christine; Department of Medical Oncology-Haematology, AZ Klina, Antwerp, Belgium
Lapeire, Lore; Department of Medical Oncology, UZ Gent, Ghent, Belgium
Naert, Eline; Department of Medical Oncology, UZ Gent, Ghent, Belgium
Lauwers, Koen; Department of Anesthesiology and Algology, AZ Klina, Antwerp, Belgium
Matic, Milica; Department of Anesthesiology and Algology, Universitair Ziekenhuis Brussel, Jette, Belgium
Mebis, Jeroen; Department of Medical Oncology, Jessa Ziekenuis Campus Virga Jesse, Hasselt, Belgium
Miedema, Geertje; Department of Radiotherapy, Universitair Ziekenhuis Brussel, Jette, Belgium
Pieterbourg, Michèle; Departement of Palliative Care, Centre Hospitalier De Jolimont, La Louvière, Belgium
Plehiers, Barbara; Department of Palliative Care, CHU de Charleroi, Charleroi, Belgium
Punie, Kevin; Department of Medical Oncology and Research, Ziekenhuis Aan de Stroom Antwerpen, Antwerp, Belgium
Roblain, Françoise; Department of Palliative Care, Clinique Saint-Pierre Ottignies, Ottignies, Belgium
Schrijvers, Dirk; Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
SERRE, Charles Henri ; Centre Hospitalier Universitaire de Liège - CHU > > Direction médicale
Vandenborre, Katherine; Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium
Broecke, Anne Vanden; Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium
Van den Bulk, Heidi; Department of Medical Oncology, Imeldaziekenhuis, Bonheiden, Belgium
Vanopdenbosch, Ludo; Department of Palliative Care, AZ St Jan Brugge-Oostende, Brugge, Belgium
Van Ryckeghem, Florence; Department of Medical Oncology, AZ Glorieux, Ronse, Belgium
Verheezen, Jolanda; Department of Medical Oncology, Sint Trudo Ziekenhuis, Sint-Truiden, Belgium
Verschaeve, Vincent; Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium
Voordeckers, Mia; Department of Radiotherapy, Universitair Ziekenhuis Brussel, Jette, Belgium
Klastersky, Jean; Department of Medical Oncology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
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