Current pharmacological and non-pharmacological approaches to chemotherapy-induced peripheral neuropathy and association with awareness of clinical guidelines.

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a persistent and challenging adverse event of cancer treatment. This study aimed to describe current pharmacological and non-pharmacological approaches to CIPN and to examine their association with awareness of the Japanese clinical guideline (CIPN-GL2023).

METHODS

An online survey was distributed to healthcare professionals involved in CIPN management, including physicians, pharmacists, and nurses. Participants reported whether they recommended pharmacological and non-pharmacological interventions for prevention and treatment.

RESULTS

Among 450 valid responses, 31% recommended pharmacological prevention, whereas 89% and 97% recommended pharmacological treatment for numbness and pain, respectively. Non-pharmacological strategies were recommended by 57% for prevention and 55% for treatment. Participants who were aware of the guideline were less likely to recommend pharmacological prevention and more likely to implement non-pharmacological prevention and treatment. Duloxetine, pregabalin, and mirogabalin (gabapentinoids) were commonly recommended across prevention and treatment. Guideline awareness was significantly associated with the recommendation of duloxetine for pain (65% vs. 44%, P < .01). Exercise and cryotherapy were frequently recommended for prevention, and exercise was the predominant non-pharmacological treatment. Exercise for prevention was more common as a first-line approach among guideline-aware respondents (56% vs. 35%, P = .02). Pharmacists demonstrated significantly higher guideline awareness, while nurses more frequently adopted non-pharmacological therapies.

CONCLUSIONS

Awareness of CIPN-GL2023 was associated with increased evidence-based practice, particularly through the use of duloxetine for pain and exercise for prevention. Multidisciplinary engagement and targeted efforts to reduce non-recommended practices remain important for improving CIPN management.