C Camps Herrero1, J J Reina Zoilo2, D Monge Martín3, F Caballero Martínez3, V Guillem Porta4, E Aranda Aguilar5, A Carrato Mena6, E Díaz-Rubio García7, J García-Foncillas López8, M Feijóo Saus9, R López López10. 1. Medical Oncology Service, General University Hospital of Valencia, CIBERONC, Valencia, Spain. camps_car@gva.es. 2. Medical Oncology Service, University Hospital Virgen Macarena, Seville, Spain. 3. Degree in Medicine, Department of Health Sciences, Francisco de Vitoria University, Madrid, Spain. 4. Oncology Service, Valencian Institute of Oncology Foundation, Valencia, Spain. 5. Oncology Service, University Hospital Reina Sofía, Córdoba, Spain. 6. Medical Oncology Service, University Hospital Ramon y Cajal, IRYCIS, CIBERONC, Madrid, Spain. 7. Oncology Service, Clinical Hospital San Carlos, Madrid, Spain. 8. Oncology Service of the Jiménez Díaz Foundation, Madrid, Spain. 9. Medical Oncology Service, University Hospital La Moraleja, Madrid, Spain. 10. Medical Oncology Service, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
Abstract
AIMS: To prove if there is clinical inertia in the identification and treatment of episodes of breakthrough cancer pain (BTcP), comparing actual results from clinical practice with clinical oncologists' prior perception. DESIGN: Observational and descriptive study, using information collected by practising medical oncologists, at three moments: (a) questionnaire regarding their professional judgement of the handling of patients with BTcP in their practice, (b) cross-sectional clinical screening, to detect possible existing cases of BTcP in a representative sample of their patients, (c) retrospective self-audit of clinical case histories of patients diagnosed with BTcP to find out about how it has been handled. PARTICIPANTS AND STUDY PERIOD: A random sample on a state level of 108 specialists in medical oncology. 540 patients who suffer some type of cancer pain on the designated study date for each specialist (July-December 2016). RESULTS: The global prevalence of BTcP in the study sample covered 91.3% of the patients who were suffering some type of cancer pain. Barely 2% of the doctors surveyed suspected figures around this mark. 40.9% of the cases had not been previously detected as BTcP by their doctors. Although 90% of the patients who had previously been diagnosed with BTcP received a specific analgesic treatment for the symptoms, 42% of those patients with known BTcP were not able to control their episodes of pain. CONCLUSIONS: Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.
AIMS: To prove if there is clinical inertia in the identification and treatment of episodes of breakthrough cancer pain (BTcP), comparing actual results from clinical practice with clinical oncologists' prior perception. DESIGN: Observational and descriptive study, using information collected by practising medical oncologists, at three moments: (a) questionnaire regarding their professional judgement of the handling of patients with BTcP in their practice, (b) cross-sectional clinical screening, to detect possible existing cases of BTcP in a representative sample of their patients, (c) retrospective self-audit of clinical case histories of patients diagnosed with BTcP to find out about how it has been handled. PARTICIPANTS AND STUDY PERIOD: A random sample on a state level of 108 specialists in medical oncology. 540 patients who suffer some type of cancer pain on the designated study date for each specialist (July-December 2016). RESULTS: The global prevalence of BTcP in the study sample covered 91.3% of the patients who were suffering some type of cancer pain. Barely 2% of the doctors surveyed suspected figures around this mark. 40.9% of the cases had not been previously detected as BTcP by their doctors. Although 90% of the patients who had previously been diagnosed with BTcP received a specific analgesic treatment for the symptoms, 42% of those patients with known BTcP were not able to control their episodes of pain. CONCLUSIONS: Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.
Entities:
Keywords:
Breakthrough cancer pain (BTcP); Clinical inertia; Prevalence of BTcP
Authors: L S Phillips; W T Branch; C B Cook; J P Doyle; I M El-Kebbi; D L Gallina; C D Miller; D C Ziemer; C S Barnes Journal: Ann Intern Med Date: 2001-11-06 Impact factor: 25.391
Authors: Jesús García-Foncillas; Antonio Antón-Torres; Fernando Caballero-Martínez; Francisco J Campos; Margarita Feyjoo; Alfonso Gómez de Liaño; Diana Monge; Carlos Camps Journal: J Patient Exp Date: 2021-01-03