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

Author

Listed:
  • Marco Cascella

    (Division of Anesthesia and Pain Medicine, Istituto Nazionale dei Tumori, IRCCS Fondazione G. Pascale, 80100 Napoli, Italy
    Department of Electrical Engineering and Information Technologies, Università di Napoli “Federico II”, 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
    Psychiatry and Clinical Psychology Unit, Fondazione Policlinico 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.)

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.

Suggested Citation

  • Marco Cascella & Luca Miceli & Francesco Cutugno & Giorgio Di Lorenzo & Alessandro Morabito & Alfonso Oriente & Giuseppe Massazza & Alberto Magni & Franco Marinangeli & Arturo Cuomo & on behalf of the, 2021. "A Delphi Consensus Approach for the Management of Chronic Pain during and after the COVID-19 Era," IJERPH, MDPI, vol. 18(24), pages 1-13, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:24:p:13372-:d:706004
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    Citations

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    Cited by:

    1. Muwen Wang & Kecheng Zhang, 2022. "Improving Agricultural Green Supply Chain Management by a Novel Integrated Fuzzy-Delphi and Grey-WINGS Model," Agriculture, MDPI, vol. 12(10), pages 1-19, September.
    2. Puthearath Chan, 2022. "An Empirical Study on Data Validation Methods of Delphi and General Consensus," Data, MDPI, vol. 7(2), pages 1-16, January.
    3. Danielle Ruskin & Julia Borsatto & Klaudia Szczech & Monique Tremblay & Lisa N. D’Alessandro & Giulia Mesaroli & Naiyi Sun & Catherine Munns & Jennifer Stinson, 2023. "“Working Together”: Perspectives of Healthcare Professionals in Providing Virtual Care to Youth with Chronic Pain during the COVID-19 Pandemic," IJERPH, MDPI, vol. 20(6), pages 1-17, March.

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