Year: 2018
Type: article
Study design: Observational Study
Abstract: Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics.
Source: Cancers
Authors: Sebastiano Mercadante, Paolo Marchetti, Arturo Cuomo, Augusto Caraceni, Rocco Mediati, Renato Vellucci, Massimo Mammucari, Silvia Natoli, Marzia Lazzari, Mario Dauri, Claudio Adile, Mario Airoldi, Giuseppe Azzarello, Mauro Bandera, Livio Blasi, Giacomo Cartenì, Bruno Chiurazzi, Benedetta Costanzo, Daniela Degiovanni, Flavio Fusco, Vittorio Guardamagna, Vincenzo Iaffaioli, Simeone Liguori, Loredana Palermo, Sergio Mameli, Francesco Masedu, Rodolfo Mattioli, Teresita Mazzei, Rita Melotti, Valentino Menardo, Danilo Miotti, Stefano Moroso, Gaetano Pascoletti, Stefano De Santis, Remo Orsetti, Alfonso Papa, Sergio Ricci, Elvira Scelzi, Michele Sofia, Giuseppe Tonini, Alessandro Valle, Federica Aielli, On behalf of the IOPS-MS Study Group
Institutions: La Maddalena, Sapienza University of Rome, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Azienda Ospedaliero-Universitaria Careggi, ASL Roma, University of Rome Tor Vergata, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Ospedale di Mirano, Ospedale di Circolo e Fondazione Macchi, Ospedale Antonio Cardarelli, Azienda Sanitaria Locale Alessandria, European Institute of Oncology, Ospedale Papa Giovanni XXIII, Istituto Tumori Bari, University of L'Aquila, University of Florence, University of Bologna, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Istituti Clinici Scientifici Maugeri, Azienda Sanitaria Universitaria Integrata di Trieste, Azienda sanitaria universitaria Friuli Centrale, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Ospedale Monaldi, Azienda Ospedaliera Universitaria Pisana, Ospedale Castelfranco Veneto, Aziende Socio Sanitaria Territoriale Rhodense, Università Campus Bio-Medico
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W2805632991