{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:58:18Z","timestamp":1785380298145,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001111","name":"Cancer Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001111","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite evidence of improved outcomes, people with pancreatic cancer have highly variable access to effective pain relief and palliative care. We aimed to develop evidence\u2010based, community\u2010informed standardised pathways to timely pain management and early palliative care for people with pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Recommendations<\/jats:title>\n                    <jats:p>\n                      Using a multi\u2010method, comprehensive, community engagement and evidence\u2010informed approach, we developed pathways to standardise referral to pain management and early palliative care for people with pancreatic cancer. Community engagement included representation from multidisciplinary clinicians, community groups and people with lived experience from across regions and all Australian states. We developed two pathways: (i) a pathway for pain management for people with resectable pancreatic cancer and (ii) an integrated pathway for pain management and palliative care for people with unresectable pancreatic cancer (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.pancare.org.au\/pancreatic-cancer-roadmap-projects\/pancreatic-cancer-pathways\">https:\/\/www.pancare.org.au\/pancreatic\u2010cancer\u2010roadmap\u2010projects\/pancreatic\u2010cancer\u2010pathways<\/jats:ext-link>\n                      ). Clinical guidance providing practical steps and links to evidence accompany the pathways. Key elements of the pathways included:\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>screening for pain at each encounter, comprehensive holistic assessment and management;<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>early consideration of interventional pain management in the event of refractory pain;<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>introduction of palliative care at time of diagnosis of metastatic or unresectable pancreatic cancer with links to suggested language to address potential community hesitancy; and<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>recommendation to discuss referrals for palliative care and interventional pain management at cancer multidisciplinary meetings.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Changes in Management as a Result of the Guidelines<\/jats:title>\n                    <jats:p>The pathways developed have set forth best practice standards grounded in evidence and expert consensus. The extensive clinical and community engagement ensures the relevance and ownership of these pathways. Implementation of the pathways will reduce existing variation in access and enhance the quality of care for people with pancreatic cancer. Furthermore, the pathways offer an opportunity to benchmark practice within and between services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70244","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:41:12Z","timestamp":1784180472000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Australian Pathways for Specialist Pain Management and Early Palliative Care for People With Pancreatic Cancer: Developed Using a Community Consensus Approach"],"prefix":"10.5694","volume":"224","author":[{"given":"Jennifer","family":"Philip","sequence":"first","affiliation":[{"name":"Department of Medicine University of Melbourne  Melbourne Victoria Australia"},{"name":"St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"VCCC Alliance  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-2748","authenticated-orcid":false,"given":"Melanie R.","family":"Lovell","sequence":"additional","affiliation":[{"name":"HammondCare  Sydney New South Wales Australia"},{"name":"Northern Clinical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylee","family":"Bellingham","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Garvey","sequence":"additional","affiliation":[{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory B.","family":"Crawford","sequence":"additional","affiliation":[{"name":"College of Health Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Rankin","sequence":"additional","affiliation":[{"name":"School of Population Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Burns","sequence":"additional","affiliation":[{"name":"Centre for Digital Transformation of Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2876-6580","authenticated-orcid":false,"given":"Isabel","family":"Young","sequence":"additional","affiliation":[{"name":"HammondCare  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivienne","family":"Milch","sequence":"additional","affiliation":[{"name":"Cancer Australia  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Keefe","sequence":"additional","affiliation":[{"name":"Cancer Australia  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Anderson","sequence":"additional","affiliation":[{"name":"Cancer Australia  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lawson","sequence":"additional","affiliation":[{"name":"Cancer Australia  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meinir","family":"Krishnasamy","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"VCCC Alliance  Melbourne Victoria Australia"},{"name":"Department of Nursing University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Cancer Australia \u201cPancreatic Cancer in Australia Statistics \u201d(2025) accessed May 2026 https:\/\/www.canceraustralia.gov.au\/cancer\u2010types\/pancreatic\u2010cancer\/pancreatic\u2010cancer\u2010australia\u2010statistics."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol28040244"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1697"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.08.017"},{"issue":"3","key":"e_1_2_12_6_1","first-page":"83","article-title":"Celiac Plexus Neurolysis for Pain Relief in Pancreatic Cancer","volume":"7","author":"Moore J. 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