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Papers of the Week
An international open-label randomised trial comparing a two-step approach versus the standard three-step approach of the WHO analgesic ladder in patients with cancer.
Abstract
Worldwide, cancer pain management follows the WHO three step analgesic ladder. Using weak opioids (e.g. codeine) at step two is debatable with low dose strong opioids potentially better, particularly in low and middle-income countries where weak opioids are expensive. We wanted to assess the efficiency, safety and cost of omitting step two of the WHO ladder.