Evidence map›Paper›PMID 42443855›Full record

SynthesisBMC palliative care2026

Barriers to interventional pain management in patients with cancer: a systematic review.

Elham S Alzahrani, Asrar O Abduldaiem, Abdulrahman I Alardan, Njood A Alshowigi

Abstract readSystematic Review
In one paragraph

Synthesis in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Elham S AlzahraniDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. alzahraniel@gmail.com.
Asrar O AbduldaiemDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Abdulrahman I AlardanDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Njood A AlshowigiDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSystemic opioids fail to provide adequate relief in 10-30% of advanced cancer patients due to poor response or debilitating adverse effects. While intrathecal drug delivery and neurolytic blocks offer effective alternatives, these interventions are severely underutilized due to systemic barriers, inadequate provider education, and late referrals, leaving pain undertreated in up to 40% of patients. This review aims to compile barriers to pain management interventions among patients with terminal cancer.

methodsWe searched for relevant articles up to February 2026 from PubMed, Scopus, and Web of Science. Two independent reviewers extracted data from the selected studies, including baseline information, outcomes, interventional pain management methods, patient data, physician and facility data, and barriers to different pain management interventions.

resultsWe collected 7,614 records after excluding 3,529 duplicates. Thorough screening resulted in the retrieval of 14 entries eligible for inclusion in our review. Our synthesis from 14 studies identified multi-level barriers to interventional pain management, including Intrathecal Drug Delivery Systems (IDDS) and Celiac Plexus Neurolysis (CPN). Patient-related barriers centered on lack of understanding, as well as fear of adverse effects and infection. Clinician-related obstacles were significant; 51% of pain fellows reported unmet training needs, while only 28% of hospice providers felt confident managing IDDS, leading over 80% to prefer systemic analgesics. Systemic issues included fragmented care coordination, a median two-year delay from diagnosis to IDDS implant, and a lack of standardized guidelines. Furthermore, socioeconomic disparities were evident, as racial minorities and residents of lower-income neighborhoods faced significantly lower access to these interventions.

conclusionThe underutilization of interventional pain management techniques is driven by a complex interplay of patient misconceptions, clinician training gaps, and systemic fragmentation.

Indexed as

Cancer PainHealth Services AccessibilityNeoplasmsPain ManagementAnalgesics, OpioidHumansAnalgesics, OpioidBarriersInterventional Pain ManagementMeta-AnalysisPalliative MedicineSystematic Review

Identifiers

PMID42443855
PMCPMC13647747

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.