Methods
General principles and management of cancer pain in adults
Adaptation of current pain management guidelines
Background and process
In December 2012, expert specialists in pain management and palliative care were approached by PAINSA to participate in a working group. This working group convened in March 2013 to review current international guidelines and to adapt them for South Africa. Once a working document had been completed, it was reviewed by members of the working group and other selected pain specialists.
Adaptation of current pain management guidelines
Current guidelines were identified through internet-based health sciences literature databases and Oncological and Palliative Care Societies in South Africa. Because of their ease of use and practical nature, four guidelines for the management of pain in adults and one for children were chosen as the foundation of this document. They are from the Scottish Intercollegiate Guidelines Network (SIGN)9; European Society for Medical Oncology (ESMO)10; European Association for Palliative Care (EAPC)11, National Institute for Health and Clinical Excellence (NICE)12, and World Health Organisation (WHO)13. Additional guidelines and references were consulted where necessary and appropriate. Management approaches from these guidelines were then endorsed or adapted for use in South Africa. Where necessary, readers are referred back to these original publications for key evidence supporting recommendations.
Objective
The objective of this document is to provide a reference guide to the management of pain for all healthcare providers caring for patients with cancer.
The scope and practice of medicine is always changing and new medicines and treatment modalities are constantly being introduced. As such, we have attempted to document current practice at the time of publication and it is anticipated that this guide will be updated in the future. The document is a guide only and is not intended to constitute inflexible treatment recommendations or to represent the standard of care. The recommendations here may not apply to all patients or all clinical situations, and shared decision making among a multidisciplinary treatment team is encouraged.
Target users
The guide will be useful to nurses, general practitioners, family physicians and specialists whose work will require them to assess and manage pain in patients with cancer. It will also be of interest to allied health workers, social workers, psychologists and other caregivers of people living with cancer.