Premium
Breakthrough cancer pain: The importance of the right treatment at the right time
Author(s) -
O'Hagan P.,
Mercadante S.
Publication year - 2018
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1225
Subject(s) - medicine , cancer pain , confusion , health professionals , quarter (canadian coin) , cancer , health care , dose , physical therapy , psychology , archaeology , psychoanalysis , economics , history , economic growth
Abstract Background Confusion remains over the definition of breakthrough cancer pain ( BT cP) potentially leading to delayed diagnosis and treatment. Methods An on‐line survey was conducted in four EU countries among relevant healthcare professionals and cancer patients diagnosed with BT cP. The roles of healthcare professionals ( HCP s) were examined and their knowledge and use of available medications recorded. Patients were questioned on how BT cP affected their lives and on the medications they had received/were receiving. Results There was a ‘time lag’ of 58 and 13 weeks in Germany and Spain respectively between the initial diagnosis of BT cP and its treatment. Four in ten oncologists across the four countries considered themselves not fully confident in their choice of the appropriate therapy. A quarter of patients in Germany, Italy and Spain and four in ten in France were treated only with increased dosages of the therapy already prescribed for their background pain – often morphine. Almost another quarter received morphine in addition to their treatment for background pain. Oncologists indicated a need for faster‐acting treatments revealing a potential lack of awareness of rapid onset oral opioids and patients expressed a desire for more effective pain relief and better psychological support. Conclusions There is a need for a universal definition of BT cP to facilitate earlier and more accurate diagnosis. It is essential that BT cP is treated immediately on diagnosis with therapies that more closely mirror its temporal characteristics to ensure that patients’ desire for more effective pain relief is fulfilled. Significance Many cancer patients suffered episodes of BT cP needlessly over many months due to missed diagnosis. Even after diagnosis, many physicians were not fully confident in their choice of ‘rescue’ therapy which perhaps is not surprising given the very low level of awareness of treatment guidelines, both national and international.