Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey

Augusto Caraceni, Cinzia Martini, Ernesto Zecca, Russell K. Portenoy, M. A. Ashby, G. Hawson, K. A. Jackson, N. Lickiss, N. Muirden, M. Pisasale, D. Moulin, V. N. Schulz, M. A Rico Pazo, J. A. Serrano, H. Andersen, H. T. Henriksen, I. Meljholm, P. Sjogren, T. Heiskanen, E. KalsoP. Pere, R. Poyhia, E. Vuorinen, I. Tigerstedt, P. Ruismaki, M. Bertolino, F. Larue, J. Y. Ranchere, G. Hege-Scheuing, I. Bowdler, F. Helbing, E. Kostner, L. Radbruch, K. Kastrinaki, S. Shah, S. Vijayaram, K. S. Sharma, P. Sarashawathi Devi, P. N. Jain, P. V. Ramamani, A. Beny, C. Brunelli, M. Maltoni, S. Mercadante, R. Plancarte, S. Schug, P. Engstrand, A. F. Ovalle, X. Wang, M. Ferraz Alves, M. R. Abrunhosa, W. Z. Sun, L. Zhang, A. Gazizov, M. Vaisman, S. Rudoy, M. Gomez Sancho, P. Vila, J. Trelis, P. Chaudakshetrin, M. L J Koh, R. T M Van Dongen, A. Vielvoye-Kerkmeer, M. V. Boswell, T. Elliott, E. Hargus, L. Lutz

Research output: Contribution to journalArticle

Abstract

Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force of the International Association for the Study of Pain (IASP) evaluated the prevalence and characteristics of BKP as part of a prospective, cross-sectional survey of cancer pain. Fifty-eight clinicians in 24 countries evaluated a total of 1095 patients with cancer pain using patient-rated items from the Brief Pain Inventory (BPI) and observer-rated measures. The observer-rated information included demographic and tumor-related data, the occurrence of BKP, and responses on checklists of pain syndromes and pathophysiologies. The clinicians reported BKP in 64.8% of patients. Physicians from English-speaking countries were significantly more likely to report BKP than other physicians. BKP was associated with higher pain scores and functional interference on the BPI. Multivariate analysis showed an independent association of BKP with the presence of more than one pain, a vertebral pain syndrome, pain due to plexopathy, and English-speaking country. These data confirm the high prevalence of BKP, its association with more severe pain and functional impairment, and its relationship to specific cancer pain syndromes. Further studies are needed to characterize subtypes of BKP. The uneven distribution of BKP reporting across pain specialists from different countries suggests that more standardized methods for diagnosing BKP are needed.

Original languageEnglish
Pages (from-to)177-183
Number of pages7
JournalPalliative Medicine
Volume18
Issue number3
DOIs
Publication statusPublished - 2004

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Breakthrough Pain
Pain
Cancer Pain
Surveys and Questionnaires
Physicians
Equipment and Supplies
Advisory Committees
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Keywords

  • Breakthrough pain
  • Cancer pain
  • Cancer pain classification
  • Cancer pain syndromes
  • IASP Task Force on Cancer Pain

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)

Cite this

Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. / Caraceni, Augusto; Martini, Cinzia; Zecca, Ernesto; Portenoy, Russell K.; Ashby, M. A.; Hawson, G.; Jackson, K. A.; Lickiss, N.; Muirden, N.; Pisasale, M.; Moulin, D.; Schulz, V. N.; Pazo, M. A Rico; Serrano, J. A.; Andersen, H.; Henriksen, H. T.; Meljholm, I.; Sjogren, P.; Heiskanen, T.; Kalso, E.; Pere, P.; Poyhia, R.; Vuorinen, E.; Tigerstedt, I.; Ruismaki, P.; Bertolino, M.; Larue, F.; Ranchere, J. Y.; Hege-Scheuing, G.; Bowdler, I.; Helbing, F.; Kostner, E.; Radbruch, L.; Kastrinaki, K.; Shah, S.; Vijayaram, S.; Sharma, K. S.; Sarashawathi Devi, P.; Jain, P. N.; Ramamani, P. V.; Beny, A.; Brunelli, C.; Maltoni, M.; Mercadante, S.; Plancarte, R.; Schug, S.; Engstrand, P.; Ovalle, A. F.; Wang, X.; Ferraz Alves, M.; Abrunhosa, M. R.; Sun, W. Z.; Zhang, L.; Gazizov, A.; Vaisman, M.; Rudoy, S.; Gomez Sancho, M.; Vila, P.; Trelis, J.; Chaudakshetrin, P.; Koh, M. L J; Van Dongen, R. T M; Vielvoye-Kerkmeer, A.; Boswell, M. V.; Elliott, T.; Hargus, E.; Lutz, L.

In: Palliative Medicine, Vol. 18, No. 3, 2004, p. 177-183.

Research output: Contribution to journalArticle

Caraceni, A, Martini, C, Zecca, E, Portenoy, RK, Ashby, MA, Hawson, G, Jackson, KA, Lickiss, N, Muirden, N, Pisasale, M, Moulin, D, Schulz, VN, Pazo, MAR, Serrano, JA, Andersen, H, Henriksen, HT, Meljholm, I, Sjogren, P, Heiskanen, T, Kalso, E, Pere, P, Poyhia, R, Vuorinen, E, Tigerstedt, I, Ruismaki, P, Bertolino, M, Larue, F, Ranchere, JY, Hege-Scheuing, G, Bowdler, I, Helbing, F, Kostner, E, Radbruch, L, Kastrinaki, K, Shah, S, Vijayaram, S, Sharma, KS, Sarashawathi Devi, P, Jain, PN, Ramamani, PV, Beny, A, Brunelli, C, Maltoni, M, Mercadante, S, Plancarte, R, Schug, S, Engstrand, P, Ovalle, AF, Wang, X, Ferraz Alves, M, Abrunhosa, MR, Sun, WZ, Zhang, L, Gazizov, A, Vaisman, M, Rudoy, S, Gomez Sancho, M, Vila, P, Trelis, J, Chaudakshetrin, P, Koh, MLJ, Van Dongen, RTM, Vielvoye-Kerkmeer, A, Boswell, MV, Elliott, T, Hargus, E & Lutz, L 2004, 'Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey', Palliative Medicine, vol. 18, no. 3, pp. 177-183. https://doi.org/10.1191/0269216304pm890oa
Caraceni, Augusto ; Martini, Cinzia ; Zecca, Ernesto ; Portenoy, Russell K. ; Ashby, M. A. ; Hawson, G. ; Jackson, K. A. ; Lickiss, N. ; Muirden, N. ; Pisasale, M. ; Moulin, D. ; Schulz, V. N. ; Pazo, M. A Rico ; Serrano, J. A. ; Andersen, H. ; Henriksen, H. T. ; Meljholm, I. ; Sjogren, P. ; Heiskanen, T. ; Kalso, E. ; Pere, P. ; Poyhia, R. ; Vuorinen, E. ; Tigerstedt, I. ; Ruismaki, P. ; Bertolino, M. ; Larue, F. ; Ranchere, J. Y. ; Hege-Scheuing, G. ; Bowdler, I. ; Helbing, F. ; Kostner, E. ; Radbruch, L. ; Kastrinaki, K. ; Shah, S. ; Vijayaram, S. ; Sharma, K. S. ; Sarashawathi Devi, P. ; Jain, P. N. ; Ramamani, P. V. ; Beny, A. ; Brunelli, C. ; Maltoni, M. ; Mercadante, S. ; Plancarte, R. ; Schug, S. ; Engstrand, P. ; Ovalle, A. F. ; Wang, X. ; Ferraz Alves, M. ; Abrunhosa, M. R. ; Sun, W. Z. ; Zhang, L. ; Gazizov, A. ; Vaisman, M. ; Rudoy, S. ; Gomez Sancho, M. ; Vila, P. ; Trelis, J. ; Chaudakshetrin, P. ; Koh, M. L J ; Van Dongen, R. T M ; Vielvoye-Kerkmeer, A. ; Boswell, M. V. ; Elliott, T. ; Hargus, E. ; Lutz, L. / Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. In: Palliative Medicine. 2004 ; Vol. 18, No. 3. pp. 177-183.
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T1 - Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey

AU - Caraceni, Augusto

AU - Martini, Cinzia

AU - Zecca, Ernesto

AU - Portenoy, Russell K.

AU - Ashby, M. A.

AU - Hawson, G.

AU - Jackson, K. A.

AU - Lickiss, N.

AU - Muirden, N.

AU - Pisasale, M.

AU - Moulin, D.

AU - Schulz, V. N.

AU - Pazo, M. A Rico

AU - Serrano, J. A.

AU - Andersen, H.

AU - Henriksen, H. T.

AU - Meljholm, I.

AU - Sjogren, P.

AU - Heiskanen, T.

AU - Kalso, E.

AU - Pere, P.

AU - Poyhia, R.

AU - Vuorinen, E.

AU - Tigerstedt, I.

AU - Ruismaki, P.

AU - Bertolino, M.

AU - Larue, F.

AU - Ranchere, J. Y.

AU - Hege-Scheuing, G.

AU - Bowdler, I.

AU - Helbing, F.

AU - Kostner, E.

AU - Radbruch, L.

AU - Kastrinaki, K.

AU - Shah, S.

AU - Vijayaram, S.

AU - Sharma, K. S.

AU - Sarashawathi Devi, P.

AU - Jain, P. N.

AU - Ramamani, P. V.

AU - Beny, A.

AU - Brunelli, C.

AU - Maltoni, M.

AU - Mercadante, S.

AU - Plancarte, R.

AU - Schug, S.

AU - Engstrand, P.

AU - Ovalle, A. F.

AU - Wang, X.

AU - Ferraz Alves, M.

AU - Abrunhosa, M. R.

AU - Sun, W. Z.

AU - Zhang, L.

AU - Gazizov, A.

AU - Vaisman, M.

AU - Rudoy, S.

AU - Gomez Sancho, M.

AU - Vila, P.

AU - Trelis, J.

AU - Chaudakshetrin, P.

AU - Koh, M. L J

AU - Van Dongen, R. T M

AU - Vielvoye-Kerkmeer, A.

AU - Boswell, M. V.

AU - Elliott, T.

AU - Hargus, E.

AU - Lutz, L.

PY - 2004

Y1 - 2004

N2 - Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force of the International Association for the Study of Pain (IASP) evaluated the prevalence and characteristics of BKP as part of a prospective, cross-sectional survey of cancer pain. Fifty-eight clinicians in 24 countries evaluated a total of 1095 patients with cancer pain using patient-rated items from the Brief Pain Inventory (BPI) and observer-rated measures. The observer-rated information included demographic and tumor-related data, the occurrence of BKP, and responses on checklists of pain syndromes and pathophysiologies. The clinicians reported BKP in 64.8% of patients. Physicians from English-speaking countries were significantly more likely to report BKP than other physicians. BKP was associated with higher pain scores and functional interference on the BPI. Multivariate analysis showed an independent association of BKP with the presence of more than one pain, a vertebral pain syndrome, pain due to plexopathy, and English-speaking country. These data confirm the high prevalence of BKP, its association with more severe pain and functional impairment, and its relationship to specific cancer pain syndromes. Further studies are needed to characterize subtypes of BKP. The uneven distribution of BKP reporting across pain specialists from different countries suggests that more standardized methods for diagnosing BKP are needed.

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KW - Breakthrough pain

KW - Cancer pain

KW - Cancer pain classification

KW - Cancer pain syndromes

KW - IASP Task Force on Cancer Pain

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