Active study: undetected prevalence and clinical inertia in the treatment of breakthrough cancer pain (BTcP)

Abstract

Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.

Prevalence and characterization of breakthrough pain in patients with cancer in Spain: the CARPE-DIO study

“…Clinical presentation is heterogeneous, and therefore, breakthrough pain cannot be considered as a single entity. However, uniform breakthrough pain has an important impact on a patient’s functionality, which supports the need for early detection and treatment, especially considering that some surveys indicate that breakthrough pain is frequently undetected 17 and undertreated 24,28 , and our results indicate that over 40% of patients are able to foretell the occurrence of BTP episodes.…”

“…Thus, in a recent study conducted by 108 medical oncologists, Camps et al . reported a prevalence of 91% of BTP using the Davies algorithm 17 . We think that the selection of patients in that study could explain, at least in part, this high prevalence of BTP; these authors selected patients who, before the start of the study, had been treated by the participant oncologists as patients suffering some kind of cancer-related pain 17 .…”

“…reported a prevalence of 91% of BTP using the Davies algorithm 17 . We think that the selection of patients in that study could explain, at least in part, this high prevalence of BTP; these authors selected patients who, before the start of the study, had been treated by the participant oncologists as patients suffering some kind of cancer-related pain 17 . In contrast, we based our selection on all patients with cancer seen at the participant sites, except for patients seen at pain units, regardless of whether they had cancer-related pain.…”

“…Very recently, Camps et al . reported the results of a survey conducted by 108 medical oncologists throughout Spain and found that 493 (91%) of the 540 patients evaluated exhibited BTP also using the Davies algorithm; more importantly, over 40% of the cases of BTP had not been previously detected by the medical oncologist 17 .…”

Consensus statement on the management of breakthrough cancer pain: Assessment, treatment and monitoring recommendations

“…In fact, a study by the American Pain Foundation showed that living with pain negatively infl uences emotional health and causes suffering in 82% of patients [25]. However, despite its prevalence and impact on patients, BTcP is sometimes unrecognized and often undertreated [26][27][28]. Prompt and effi cient diagnosis is therefore essential.…”