Keita Tagami1,2, Ayumi Okizaki1, Tomofumi Miura1,3, Yuki Sumazaki Watanabe1, Yoshihisa Matsumoto1, Tatsuya Morita4, Maiko Fujimori5,6, Hiroya Kinoshita1,7. 1. 1 Department of Palliative Medicine, National Cancer Center Hospital East , Kashiwa, Japan . 2. 2 Department of Palliative Medicine, Tohoku University School of Medicine , Sendai, Japan . 3. 3 Division of Biomarker Discovery, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East , Kashiwa, Japan . 4. 4 Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital , Hamamatsu, Japan . 5. 5 Division of Cohort Consortium Research, Center for Public Health Sciences, National Cancer Center , Tokyo, Japan . 6. 6 Division of Health Care Research, Center for Public Health Sciences, National Cancer Center , Tokyo, Japan . 7. 7 Department of Palliative Care, Tokatsu Hospital , Nagareyama, Japan .
Abstract
BACKGROUND: Breakthrough cancer pain (BTcP) is a predictor of interference with general activities and poor pain management. The extent of this influence has not yet been determined. OBJECTIVE: This study aimed to investigate the influence of BTcP on general activities, and pain management in patients with controlled background pain. DESIGN: Single-center prospective observational study. SETTING/ SUBJECTS: The study cohort comprised 258 consecutive patients (female, 40.0%; mean age, 64.5 years) who had received opioid medication for cancer pain for over 2 weeks. MEASUREMENTS: A recommended diagnostic algorithm was used to quantitate and compare interference with general activities, average background pain intensity over the previous 24 hours (24h-PI), and achievement of personalized pain goals (PPGs) (24h-PI≤PPG) of 119 patients with and 139 patients without BTcP. RESULTS: Interference with general activities, 24h-PI, and PPG scores [mean (standard deviation)] in patients with BTcP were 2.8 (2.2), 3.0 (1.7), and 1.8 (1.4), respectively, which are all significantly higher than for those without BTcP [1.3 (2.0), p < 0.01; 1.7 (1.6), p < 0.01; 1.5 (1.3), p = 0.03], respectively. A significantly smaller percentage of patients with BTcP than without BTcP achieved their PPGs (36.1% vs. 67.6%, p < 0.01). CONCLUSIONS: BTcP has a negative impact on general activities and pain management. Healthcare providers should recognize that management of BTcP is important in improving general activities and management of cancer pain.
BACKGROUND:Breakthrough cancer pain (BTcP) is a predictor of interference with general activities and poor pain management. The extent of this influence has not yet been determined. OBJECTIVE: This study aimed to investigate the influence of BTcP on general activities, and pain management in patients with controlled background pain. DESIGN: Single-center prospective observational study. SETTING/ SUBJECTS: The study cohort comprised 258 consecutive patients (female, 40.0%; mean age, 64.5 years) who had received opioid medication for cancer pain for over 2 weeks. MEASUREMENTS: A recommended diagnostic algorithm was used to quantitate and compare interference with general activities, average background pain intensity over the previous 24 hours (24h-PI), and achievement of personalized pain goals (PPGs) (24h-PI≤PPG) of 119 patients with and 139 patients without BTcP. RESULTS: Interference with general activities, 24h-PI, and PPG scores [mean (standard deviation)] in patients with BTcP were 2.8 (2.2), 3.0 (1.7), and 1.8 (1.4), respectively, which are all significantly higher than for those without BTcP [1.3 (2.0), p < 0.01; 1.7 (1.6), p < 0.01; 1.5 (1.3), p = 0.03], respectively. A significantly smaller percentage of patients with BTcP than without BTcP achieved their PPGs (36.1% vs. 67.6%, p < 0.01). CONCLUSIONS:BTcP has a negative impact on general activities and pain management. Healthcare providers should recognize that management of BTcP is important in improving general activities and management of cancer pain.
Entities:
Keywords:
breakthrough cancer pain; cancer pain; pain interference with general activities; pain management; personalized pain goal
Authors: Virginia LeBaron; Rachel Bennett; Ridwan Alam; Leslie Blackhall; Kate Gordon; James Hayes; Nutta Homdee; Randy Jones; Yudel Martinez; Emmanuel Ogunjirin; Tanya Thomas; John Lach Journal: JMIR Form Res Date: 2020-08-26
Authors: Marco Mazzotta; Marco Filetti; Marta Piras; Sebastiano Mercadante; Paolo Marchetti; Raffaele Giusti Journal: Cancer Manag Res Date: 2022-03-24 Impact factor: 3.989