title: How Do Hospital Palliative Care Teams Use the WHO Guidelines to Manage Unrelieved Cancer Pain? A 1-Year, Multicenter Audit in Japan.
abstract: It has been reported that pain relief for patients with cancer is suboptimal in Japan. This has been mainly attributed to inadequate dissemination of the World Health Organization (WHO) guidelines for cancer pain management. To better understand this problem, we reviewed how 6 hospital palliative care teams (HPCTs) used the WHO guidelines for unrelieved pain in a 1-year audit that included 534 patients. The HPCT interventions were classified according to the contents of the WHO guidelines. In our study, HPCT interventions involved opioid prescriptions in >80% of referred patients, and "For the Individual" and "Attention to Detail" were the 2 most important principles. Our study indicates which parts of the WHO guidelines should be most heavily emphasized, when disseminating them in Japan.
authors.affiliation: 1 Department of Palliative and Supportive Care, Chukyo Hospital, Aichi, Japan.
authors.forename: Tetsusuke
authors.initials: T
authors.lastname: Yoshimoto
authors.affiliation: 2 Department of Anesthesia and Palliative Care, Nishida Hospital, Saga, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tomiyasu
authors.affiliation: 3 Department of Palliative Care Medicine, Municipal Miyoshi Central Hospital, Hiroshima, Japan.
authors.forename: Toshinari
authors.initials: T
authors.lastname: Saeki
authors.affiliation: 4 Department of Palliative Care, Cancer Center, Hokkaido University Hospital, Hokkaido, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: 5 Hashizume Clinic, Akita, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hashizume
authors.affiliation: 6 Department of Palliative Care Medicine, Iwate Prefectural Ofunato Hospital, Iwate, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Murakami
authors.affiliation: 7 Department of Palliative Care Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Matoba
mesh_terms: D000072716:Cancer Pain / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods / Q000592:standards*; D010166:Palliative Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D010348:Patient Care Team; D012189:Retrospective Studies; D014944:World Health Organization
keywords: WHO guidelines; analgesics; audit; cancer pain relief; opioid; palliative care team