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Abstract
Context
Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.
Objectives
The aim of this study was to characterize breakthrough pain in a diverse population of cancer patients.
Methods
The
study involved 1000 cancer patients from 13 European countries.
Patients were screened for breakthrough pain using a recommended
diagnostic algorithm and then questioned about the characteristics and
management of their pain.
Results
Of
the 1000 patients, 44% reported incident pain, 41.5% spontaneous pain,
and 14.5% a combination. The median number of episodes was three a day.
The median time to peak intensity was 10 minutes, with the median for
patients with incident pain being five minutes (P < 0.001).
The median duration of untreated episodes was 60 minutes, with the
median for patients with incident pain being 45 minutes (P = 0.001).
Eight hundred six patients stated that pain stopped them doing
something, 66 that it sometimes stopped them doing something, and only
107 that it did not interfere with their activities. Patients with
incident pain reported more interference with walking ability and normal
work, whereas patients with spontaneous pain reported more interference
with mood and sleep. As well, 65.5% of patients could identify an
intervention that improved their pain (29.5%, pharmacological; 23%,
nonpharmacological; 12%, combination). Regarding medications, 980
patients were receiving an opioid to treat their pain, although only 191
patients were receiving a transmucosal fentanyl product licensed for
the treatment of breakthrough pain.
Conclusion
Breakthrough cancer pain is an extremely heterogeneous condition.
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