Early and Multidisciplinary Management of Chronic Noncancer Pain and Conceptualization of Central Sensitization in Spain: Delphi CADOR Study

Pain Res Manag. 2026;2026(1):e1295794. doi: 10.1155/prm/1295794.

ABSTRACT

BACKGROUND: The CADOR study aimed to obtain consensus on the diagnosis, management, and follow-up of patients with chronic noncancer pain (CNCP) in Spain, including beliefs about central sensitization (CS), and addressing multidisciplinary care and referral processes.

METHODS: A Delphi consensus of two successive rounds (July 2023-November 2023) among 100 panelists working in Primary Care (PC), Traumatology, Rehabilitation, and Pain Units (Anesthesiology) was performed. Consensus was defined as ≥ 70% of panelists agreeing or disagreeing with a statement. The questionnaire included 30 questions with some Likert-type scale items systematized as follows: 1 to 3 (disagreement), 4 to 6 (neutral), and 7 to 9 (agreement). A scientific committee (SC) of five experts in the field validated the questionnaire and its results.

RESULTS: Panelists considered pain as an entity and underlined the need to include it in medical records. CNCP should be addressed holistically and managed by a multidisciplinary team. Experts agreed to specifically investigate the presence of pain in patients with mood disorders and among the elderly. Moreover, the panelists considered it important to highlight the role of CS in CNCP evolution, a concept not well established in real clinical practice. Panelists emphasized the need to enhance knowledge to prevent the chronification of pain, address symptoms potentially associated with CS, and to improve patients' prognosis. Finally, panelists highlighted the need for ongoing training initiatives for clinicians and patients, promoting awareness, with a particular focus on the patients' needs.

CONCLUSION: This study underscores the importance of early detection, personalized treatment, and structured follow-up for the correct therapeutic approach of CNCP in the Spanish setting. These recommendations may also help to anticipate symptoms potentially associated with CS by improving conceptual understanding in CNCP patients. Finally, respondents also highlighted the relevance of multidisciplinary care and referral processes in patients with CNCP.

PMID:42830660 | DOI:10.1155/prm/1295794