Epidemiology and pattern of care of cancer related breakthrough pain in Czech Republic Results of research project PARMA (Pain Relief Management). Part 2., Management of breakthrough pain and patient satisfaction with care
Abstract
A questionary survey among 474 cancer patients treated with strong opioids on regular basis for background pain in Czech oncological, pain- and palliative services. The prevalence of any form of breakthrough pain (BtP) was 75%.
The medication used for management of BtP was oral morpine, non-opioids, oral tramadol, parenteral morphine, combination of opioids and non-opioids and transmucosal fentanyl in 35%, 20%, 15%, 11%, 17% and 1% respectively. The time to pain relief for oral morpine, non-opioids, oral tramadol, parenteral morphine, and transmucosal fentanyl was 21-30 min, 15-40 min, 30-40 min, 6-10 min and 16-20 min respectively. 72% patients were satisfied with the management of their BtP.
Lower satisfaction (only 50%) was found among patients with 3-4 episodes of BtP per day and among those treated with non-opioids a tramadol (satisfaction rate 64% and 58% respectively). To assess the relation between background pain management and prevalence and clinical characteristics of BtP as well as the optimal strategy of BtP management of different types of BtP on longitudinal prospective design of the survey would be needed.