Epidemiology and pattern of care of cancer related breakthrough pain in Czech Republic Results of research project PARMA (Pain Relief Management). Part 1., Prevalence and clinical characteristics of breakthrough cancer pain
Abstract
Surveys conducted in different countries and settings have described cancer breakthrough pain (CBTP) prevalence from 19% to 95%. Aim: To describe the CBTP in different clinical settings in Czech Republic as for prevalence, clinical characteristics, treatment strategies used and patient satisfaction.
Method: A survey among cancer patients treated by oncologists and palliative care and pain specialists. Cooperating physicians distributed the questionary to unselected consecutive cancer patients in their office, who have been using for their pain strong opioids.
Results: 474 patients completed the questionary. The "average" intensity of background pain was 0-4/10 in 74% (group A) and 5-10/10 in 26% (group B).
The prevalence of CBTP was 71% in group A, 86% in group B. The duration of the episode of CBTP was 30-60 minutes in more than 50% of patiens.
The number of CBTP episodes was 1-4 per day in 64% (median 3). More than 30% of patiens reported less than 1 episode per day.
The intensity of CBTP in group A was severe and moderate in 56% and 46% respectively and severe in 96% in group B. The intensity of BCTP was in average 2 points higher than the reported background pain intensity Conclusion: CBTP is a very prevalent but heterogenous clinical phenomenon which should be assessed and managed in context with the background pain management.
Longitudinal design of the study would be necessary to capture the impact of CBTP on patiens quality of life as well as the effectiveness of different therapeutic strategies.