The Improving Opioid Use for Cancer Pain Framework: Addressing the needs of patients with cancer and pain in a new era of opioid prescribing
Cette étude présente des recommandations visant à améliorer les stratégies d'utilisation des opioïdes pour la prise en charge de la douleur liée au cancer
Opioids are essential for cancer pain management, but growing knowledge about their risks and limited effectiveness requires careful consideration in cancer pain guidelines and practice. To better address these issues, an adult cancer pain and opioid framework was developed through structured literature analysis and expert input, focusing on the clinician–patient relationship and clinical practice. The framework was developed by compiling an initial list of concepts from guidelines and adaptation through crosswalking with key guidelines and a literature search and review. The concepts were organized into an initial draft framework before iterative refinement with input from the research team and content experts. The Improving Opioid Use for Cancer Pain Framework is centered on the whole-person approach to those with cancer, particularly the concepts of biopsychosocial cancer pain and person-centered care, including communication and shared decision-making. The goals of cancer pain management in the framework are enhancing comfort while minimizing adverse events, burden, and safety risks, with opioids considered as one tool in a comprehensive toolbox. Nonopioid strategies should be the first choice or the ultimate goal when possible and should always be used alongside opioids, with multimodal approaches often ideal. Clinicians should consider opioid effectiveness, burden, and risks, including adverse effects and risks for long-term use. Sufficient evidence now supports adoption of a more balanced approach to cancer pain management. Better use of multimodal nonopioid and nonpharmacologic pain management resources can improve cancer pain management without limiting opioid use for those who need it.
Cancer , résumé, 2026