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Publicación del Proyecto 25Q

Background: Current guidelines on the management of cancer pain include information referred to integral patient management, in order to get an improvement in their quality of care. The assessment of compliance with the recommendations in daily practice constitutes a necessary feedback mechanism for consolidating theoretical recommendations. The objective of the study was to evaluate the fulfilment of quality of care recommendations for patients with cancer pain in real clinical practice.

Methods: A retrospective observational study was designed. A total of 107 centres (81 pain units and 26 palliative care units) collected pooled information on 1605 patients. The study coordinating committee selected 12 structure and 13 process quality indicators based on the recommendations of different clinical practice guidelines. The process indicators were evaluated through the information obtained from 15 consecutively and retrospectively selected case histories. For each indicator, the participating physicians specified compliance or non-compliance, or whether the indicator measurement was not applicable to the reviewed patient. The degree of compliance with the recommendations on the management of patients with cancer pain was evaluated using the Achievable Benchmarks of Care (ABC)© (University of Alabama, Birmingham, AL, USA).

Results: Mean compliance with all the indicators was 82.4% (95% CI 70.4–94.4). The ABC of the 13 process indicators selected for the study was 100%. No relevant differences were observed in the degree of compliance with the quality indicators between pain and palliative care units, or between geographical areas.

Conclusions: The selected recommendations are applicable to clinical practice and could be used to continuous evaluation of quality of care in patients with cancer. Compliance with the quality indicators in the participating units was very satisfactory.

Keywords: Quality measurement, Quality improvement, Quality indicators, Benchmarking, Cancer, Palliative care