Breakthrough cancer pain: a comparison of surveys with European and Canadian patients

Bedard, Gillian; Davies, Andrew; McDonald, Rachel; Hawley, Philippa; Buchanan, Alison; Popović, Marko; Wong, Erin; Chow, Edward

doi:10.1007/s00520-014-2426-6

Cited by 25 publications

(24 citation statements)

References 15 publications

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“…We found that the prevalence of BTP varied between countries, from 14% to 75%, in contrast to other studies 8 29. There may be different reasons for this, in particular, that the other studies were specifically designed to characterise BTP, while ours was not.…”

Section: Discussioncontrasting

confidence: 90%

“…The Bedard et al 29 study also used a specifically developed registration tool for presence and management of BTP, and found no differences in the incidence of BTP when comparing data from 94 Canadian and 1000 European PC patients. On the other hand, an international survey published in 2004 demonstrated that physicians from English-speaking countries were significantly more likely to report BTP than were physicians from other countries 7.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer

Hjermstad

Kaasa

Caraceni

et al. 2016

BMJ Support Palliat Care

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer

Hjermstad

Kaasa

Caraceni

et al. 2016

BMJ Support Palliat Care

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“…In an Italian survey, 21 of 118 physicians at dedicated palliative care institutions select fentanyl alone or fentanyl with other opioids as their drug of choice for controlling BTcP (15). On the other hand, the percentage of Canadian patients with BTcP who had been prescribed fentanyl was only 2.9% (16). Based on comparison with the physician surveys of other countries, transmucosal fentanyl is used more frequently in Korea than in Canada, but less frequently than in European countries.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, a mismatch between temporal characteristics of BTcP and the mechanisms of rescue medications may result in suboptimal pain management and undesirable adverse effects for patients, such as sedation, confusion, and fatigue (14). Recent research in other countries has shown that many physicians still use conventional rescue medications despite the availability of more appropriate opioids (15,16). However, there is little data regarding the management of BTcP among Korean physicians.…”

Section: Introductionmentioning

confidence: 99%

Physician’s Attitude toward Treating Breakthrough Cancer Pain in Korea

Seo

Shim

Choi

et al. 2017

Korean J Hosp Palliat Care

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Purpose: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. Methods: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. Results: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. Conclusion: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.

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“…The prevalence of BTP has been reported to range from 40% to 80% and is associated with patients' morbidity . In consideration of its impacts on cancer patients, adequate management of BTP is required but is still suboptimal …”

Section: Introductionmentioning

confidence: 99%

A dose titration study of fentanyl buccal soluble film for breakthrough cancer pain in Taiwan

Chiou

Chao

et al. 2019

Cancer Reports

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Background: Fentanyl buccal soluble film (FBSF), a new formulation of fentanyl, is developed for the treatment of breakthrough pain (BTP) in opioid-tolerant patients with cancer.Aims: This study aimed to assess the feasible dose range of FBSF required for Taiwanese population. Methods and results:This was an open-label, multicenter, noncomparative study.Cancer patients who were aged 20 years or older and had a stable regimen equivalent to 60 to 1000 mg/day of oral morphine, 20 to 120 mg/day of intravenous morphine, or 25 to 300 μg/h of transdermal fentanyl for at least 1 week were enrolled. The primary endpoint was the feasible dose range of FBSF. Secondary endpoints included difference in pain intensity at 30 minutes (PID30), percentage of episodes requiring rescue medication, and overall satisfaction. Adverse events (AEs) and serious AEs (SAEs) were recorded for safety measurements. The final effective dose in the per-protocol (PP) population (n = 30) ranged from 200 to 800 μg, of which 26 subjects (86.7%) achieved an effective dose range of 200 to 400 μg. Among the 283 BTP episodes recorded in the maintenance period, the mean PID30 was 4.0, and only 13 events (4.6%) required rescue medication. For 63.6% of the BTP episodes, patients rated their satisfaction as good to excellent. Only 5% of AEs were considered drug-related. Conclusions:Individualized dose titration is recommended for BTP management for patients' benefit. Overall, FBSF was effective and well tolerated and was positively correlated with patients' background opioid dose for persistent pain management. KEYWORDSbreakthrough pain, dose titration, feasible dose range, fentanyl buccal soluble film

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Breakthrough cancer pain: a comparison of surveys with European and Canadian patients

Cited by 25 publications

References 15 publications

Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer

Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer

Physician’s Attitude toward Treating Breakthrough Cancer Pain in Korea

A dose titration study of fentanyl buccal soluble film for breakthrough cancer pain in Taiwan

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