Sebastiano Mercadante1, Augusto Caraceni2, Arturo Cuomo3, Massimo Mammucari4, Paolo Marchetti5, Rocco Domenico Mediati6, Silvia Natoli7, Giuseppe Tonini8. 1. Anesthesia and Intensive Care & Pain Relief and Supportive Care, 00185 La Maddalena, Italy. 2. Palliative Care, Pain Therapy and Rehabilitation, National Cancer Institute, IRCCS Foundation, 20133 Milan, Italy. 3. Anesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation Pascale, 80131 Naples, Italy. 4. Primary Care Unit, ASL RM1, 00193 Rome, Italy. 5. Department of Clinical and Molecular Medicine, La Sapienza University of Rome, 00185 Rome, Italy. 6. Palliative Care and Pain Therapy Unit, Careggi Hospital, 50139 Florence, Italy. 7. Department of Clinical Science and Translational Medicine-University of Rome Tor Vergata, 00133 Rome, Italy. 8. Medical Oncology Department, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
Abstract
The aim of this study was to longitudinally assess the characteristics of background pain and breakthrough pain (BTcP), analgesic treatment, and satisfaction with treatment four weeks after the first assessment. METHODS: Adult cancer patients with a diagnosis of BTcP were included. At T0, age, gender, visit setting, cancer diagnosis, the extent of the disease, ongoing anticancer treatments, and Karnofsky level were recorded. The background pain intensity in the last 24 h (on a numerical scale 0-10), opioids used for background pain, and their doses, expressed as oral morphine equivalents (OME), as well as other analgesic drugs, were recorded. The number of BTcP episodes, their intensity, predictability and precipitating factors, onset duration of untreated episodes, and interference with daily activities were collected. Analgesics and doses used for BTcP, and the mean time to meaningful pain relief after taking medication, were assessed. The level of satisfaction with BTcP medication was also assessed. Adverse effects to be attributed to these medications were also recorded. At T4, the same data were evaluated. RESULTS: After one-month follow-up, patients had a lower number of BTcP episodes and peak intensity, possibly due to the optimization of background analgesia. The principal characteristics of BTcP did not change significantly. CONCLUSION: A careful and continuous assessment should be guaranteed to all patients to limit the burden induced by BTcP, other than treating BTcP episodes with short-onset opioids.
The aim of this study was to longitudinally assess the characteristics of background pain and breakthrough pain (BTcP), analgesic treatment, and satisfaction with treatment four weeks after the first assessment. METHODS: Adult cancerpatients with a diagnosis of BTcP were included. At T0, age, gender, visit setting, cancer diagnosis, the extent of the disease, ongoing anticancer treatments, and Karnofsky level were recorded. The background pain intensity in the last 24 h (on a numerical scale 0-10), opioids used for background pain, and their doses, expressed as oral morphine equivalents (OME), as well as other analgesic drugs, were recorded. The number of BTcP episodes, their intensity, predictability and precipitating factors, onset duration of untreated episodes, and interference with daily activities were collected. Analgesics and doses used for BTcP, and the mean time to meaningful pain relief after taking medication, were assessed. The level of satisfaction with BTcP medication was also assessed. Adverse effects to be attributed to these medications were also recorded. At T4, the same data were evaluated. RESULTS: After one-month follow-up, patients had a lower number of BTcP episodes and peak intensity, possibly due to the optimization of background analgesia. The principal characteristics of BTcP did not change significantly. CONCLUSION: A careful and continuous assessment should be guaranteed to all patients to limit the burden induced by BTcP, other than treating BTcP episodes with short-onset opioids.
Authors: Anne Kari Knudsen; Cinzia Brunelli; Pål Klepstad; Nina Aass; Giovanni Apolone; Oscar Corli; Mauro Montanari; Augusto Caraceni; Stein Kaasa Journal: Pain Date: 2012-01-20 Impact factor: 6.961
Authors: Andrew Davies; Ulrich R Kleeberg; Jerzy Jarosz; Sebastiano Mercadante; Philippe Poulain; Tony O'Brien; Hélène Schneid; Hans G Kress Journal: Support Care Cancer Date: 2015-01-04 Impact factor: 3.603