Ng Jeremy Y, Sharma Alisha E
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Pain Pract. 2021 Apr;21(4):454-467. doi: 10.1111/papr.12964. Epub 2020 Dec 4.
Although up to 85% of patients with cancer use complementary and alternative medicine (CAM), they commonly do not disclose this information to their healthcare providers. Cancer-related pain (CRP) is one of the most common symptoms among those who may seek CAM. This study was conducted to identify the quantity and assess the quality of CAM recommendations across clinical practice guidelines (CPGs) for the treatment and/or management of CRP, as this has not been explored in the literature.
A systematic review was conducted to identify cancer pain CPGs. MEDLINE, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from 2009 to 2020. The Guideline International Network and the National Centre for Complementary and Integrative Health websites were also searched. Eligible CPGs on CRP in adults were assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument.
Of 771 unique search results, 13 mentioned CAM and 11 made CAM recommendations. Eligible CPGs were published in 2009 or later and focused on the treatment/management of CRP. Scaled domain percentages from highest to lowest ranged from (overall, CAM): 88.1%, 88.1% (for scope and purpose) to 21.0%, 8.5% (for applicability). Quality varied within and across CPGs. One CPG was recommended by both appraisers; 6 were recommended as "Yes" or "Yes with modifications."
The present study has identified and summarized a number of CPGs that clinicians may consult to understand what CAMs are recommended in the context of the treatment and/or management of CRP.
尽管高达85%的癌症患者使用补充和替代医学（CAM），但他们通常不会向医疗服务提供者透露这一信息。癌症相关疼痛（CRP）是可能寻求CAM治疗的患者中最常见的症状之一。本研究旨在确定临床实践指南（CPG）中关于CRP治疗和/或管理的CAM推荐数量并评估其质量，因为这在文献中尚未得到探讨。
进行系统综述以确定癌症疼痛CPG。检索了2009年至2020年的MEDLINE、EMBASE以及护理与联合健康文献累积索引（CINAHL）。还检索了指南国际网络和国家补充与综合健康中心网站。使用指南研究与评价工具II（AGREE II）对符合条件的成人CRP CPG进行评估。
在771条独特的检索结果中，13条提及CAM，11条给出了CAM推荐。符合条件的CPG于2009年或之后发表，重点关注CRP的治疗/管理。从最高到最低的领域比例范围为（总体，CAM）：88.1%、88.1%（范围和目的）至21.0%、8.5%（适用性）。不同CPG内部和之间的质量存在差异。两位评估者都推荐了一份CPG；6份被推荐为“是”或“有修改的是”。
本研究识别并总结了一些CPG，临床医生可参考这些指南了解在CRP治疗和/或管理背景下推荐使用哪些CAM。
