期刊
CLINICAL & TRANSLATIONAL ONCOLOGY
卷 21, 期 9, 页码 1168-1176出版社
SPRINGER INTERNATIONAL PUBLISHING AG
DOI: 10.1007/s12094-019-02044-8
关键词
Breakthrough cancer pain; Pain units; Consensus; Opioids
类别
资金
- Grupo de trabajo de dolor oncologico of the SED (Sociedad Espanola de Dolor)
- Takeda pharmaceutics
PurposeCurrent evidence suggests the need to improve the management of breakthrough cancer pain (BTcP). For this reason, we aimed to assess the opinion of a panel of experts composed exclusively of physicians from pain units, who play a major role in BTcP diagnosis and treatment, regarding the key aspects of BTcP management.MethodsAn ad hoc questionnaire was developed to collect real-world data on the management of BTcP. The questionnaire had 5 parts: (a) organizational aspects of pain units (n=12), (b) definition and diagnosis (n=3), (c) screening (n=3), (d) treatment (n=8), and (e) follow-up (n=7).ResultsA total of 89 pain-unit physicians from 13 different Spanish regions were polled. Most of them agreed on the traditional definition of BTcP (78.9%) and the key features of BTcP (92.1%). However, only 30.3% of participants used the Davies' algorithm for BTcP diagnosis. Respondents preferred to prescribe rapid-onset opioids [mean 77.0% (SD 26.7%)], and most recommended transmucosal fentanyl formulations as the first option for BTcP. There was also considerable agreement (77.5%) on the need for early follow-up (48-72h) after treatment initiation. Finally, 65.2% of participants believed that more than 10% of their patients underused rapid-onset opioids.ConclusionsThere was broad agreement among pain experts on many important areas of BTcP management, except for the diagnostic method. Pain-unit physicians suggest that rapid-onset opioids may be underused by BTcP patients in Spain, an important issue that need to be evaluated in future studies.
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