Current management of breakthrough cancer pain according to physicians from pain units in Spain
Por:
Estevez F, Alarcon M, Mayoral V, de Madariaga M, Margarit C, Duran J, Martin-Arroyo J, Carregal A, SED
Publicada:
1 sep 2019
Resumen:
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.
Filiaciones:
Estevez F:
Consorcio Hosp Prov Castellon, Pain Unit, Castellon de La Plana, Spain
Alarcon M:
Univ Valencia, Hosp Gen, Pain Unit, Valencia, Spain
Mayoral V:
Hosp Univ Bellvitge, Pain Unit, Barcelona, Spain
de Madariaga M:
Hosp Univ Infanta Sofia, Pain Unit, Madrid, Spain
Margarit C:
Univ Alicante, Hosp Gen, Pain Unit, Alicante, Spain
Duran J:
Hosp Univ Nuestra Senora Candelaria, Hosp Santa Cruz Tenerife, Pain Unit, Tenerife, Spain
Martin-Arroyo J:
Hosp Puerta Mar, Pain Unit, Cadiz, Spain
Carregal A:
Complexo Hosp Univ Vigo CHUVI, Pain Unit, Pontevedra, Spain
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