Members of the American Pain Society (APS) have published the first update of Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain to improve quality of care since 1995. The details of these recommendations were published in the July 25, 2005, issue of the Archives of Internal Medi cine.

The control of pain related to cancer and cancer treatment is an important and often neglected part of cancer management. It is estimated that 30% to 45% of patients will have moderate to severe pain in the early and intermediate stages of cancer and 70% to 90% will have moderate to severe pain in the final stages of cancer. Cancer pain is better controlled in the hospital setting but more and more patients with cancer are being treated in the outpatient department. There is evidence that many patients receive inadequate doses of opiates to control pain. In this era of multimodality treatment it is also very important to coordinate pain management with several treating groups of physicians and nurses.

The current study involved a review of the literature between 1994 and 2004 to identify publications on pain quality measurement and quality improvement since 1995. The task force revised and expanded recommendations on the basis of this review process. The new recommendations specify that all care situations be structured to insure prompt recognition and treatment of pain. They advised involvement of families in the pain management plan and regular reassessment of how well the plan is working. These guidelines stress the re-evaluation of the pain treatment plans to make them safe, evidence based and multimodal.

Comments:  These new guidelines should assist cancer treatment teams in devising strategies for the management of pain in cancer patients.

Reference: Gordon DB, Dahl JL, Miaskowski C, et al. American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management. Archives of Internal Medicine . 2005;165:1574-1580.

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