A Delphi Consensus Approach for the Management of Chronic Pain during and after the COVID-19 Era

Marco Cascella, Luca Miceli, Francesco Cutugno, Giorgio Di Lorenzo, Alessandro Morabito, Alfonso Oriente, Giuseppe Massazza, Alberto Magni, Franco Marinangeli, Arturo Cuomo and on behalf of the DELPHI Panel
Additional contact information
Marco Cascella: Division of Anesthesia and Pain Medicine, Istituto Nazionale dei Tumori, IRCCS Fondazione G. Pascale, 80100 Napoli, Italy
Luca Miceli: Department of Pain Medicine, IRCCS C.R.O. National Cancer Institute of Aviano, 33081 Aviano, Italy
Francesco Cutugno: Department of Electrical Engineering and Information Technologies, Università di Napoli “Federico II”, 80100 Napoli, Italy
Giorgio Di Lorenzo: Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Alessandro Morabito: Thoracic Medical Oncology, Istituto Nazionale Tumori, IRCCS “Fondazione G. Pascale”, 80100 Napoli, Italy
Alfonso Oriente: Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, 80100 Napoli, Italy
Giuseppe Massazza: Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University di Torino, 10121 Torino, Italy
Alberto Magni: Italian College of General Practitioners and Primary Care (SIMG), Via Del Sansovino 179, 50142 Firenze, Italy
Franco Marinangeli: Department of Life, Health & Environmental Sciences, University of l’Aquila, 67100 l’Aquila, Italy
Arturo Cuomo: Division of Anesthesia and Pain Medicine, Istituto Nazionale dei Tumori, IRCCS Fondazione G. Pascale, 80100 Napoli, Italy
on behalf of the DELPHI Panel: Membership of the DELPHI Panel is provided in the Acknowledgment.

IJERPH, 2021, vol. 18, issue 24, 1-13

Abstract: Due to a lack of published evidence on the topic, a modified Delphi approach was used to develop recommendations useful for chronic pain management during and after the COVID-19 pandemic. Focusing on the available literature and personal clinical expertise, an Italian board of nine professionals from different disciplines identified four main topics: prevention of chronic pain, treatment of chronic pain, consequences of inadequate treatment, and perspectives. They elaborated a semi-structured questionnaire. A multidisciplinary panel of experts in the field of pain management was requested to comment on the statements. Based on the answers provided, a structured questionnaire was prepared (Round 1). It included 21 statements divided into three categories (organizational issues; diagnosis and therapies; telemedicine and future perspectives). A five-point Likert scale was adopted. The threshold for consensus was set at a minimum of 70% of the number of respondents (level of agreement ≥ 4, Agree or Strongly Agree). A final questionnaire with rephrasing of the statements that did not reach the consensus threshold was elaborated (Round 2). A total of 29 clinicians were included in the panel. Twenty clinicians (69%) responded in both the first and second round. After two rounds, consensus (≥70%) was achieved in 20 out of 21 statements. The lack of consensus was recorded for the statement regarding the management of post-COVID pain (55%; Median 4; IQR 2.3). Another statement on telemedicine reached the threshold in the first round (70%), but the value was not confirmed in Round 2 (65%; Median 4; IQR 2). Most of the proposed items reached consensus, suggesting the need to make organizational changes, the structuring of careful diagnostic and therapeutic pathways, and the application of new technologies in pain medicine. Long-COVID-19 care is an issue that needs further research. Remote assistance for chronic pain must be regulated.

Keywords: COVID-19; Delphi survey; chronic pain; telemedicine; recommendations (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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