Epidemiology and pattern of care of breakthrough cancer pain in a longitudinal sample of cancer patients: Results from the cancer pain outcome research study group

Maria Teresa Greco, Oscar Corli, Mauro Montanari, Silvia Deandrea, Vittorina Zagonel, Giovanni Apolone

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Breakthrough cancer pain (BTcP) is a frequent event in cancer patients, with a prevalence from 19% to 95%. The reasons for such variability are explained by several factors, including different definitions across studies. In the framework of a wider initiative, we have analyzed the epidemiology of BTcP and identified factors associated with the pattern of care. Methods:: This study reports the results from a multicenter, prospective, nonrandomized, longitudinal study carried out in Italy between 2006 and 2007 on patients with cancer and pain. Transient exacerbations of pain were assessed with 3 different questions, and 1 composite variable to operationally define BTcP was then used as main outcome. After univariate analysis, a logistic model was also fitted to identify prognostic and predictive factors. RESULTS: One hundred and ten centers recruited 1801 cases of which 40.3% had BTcP at baseline. Most patients did not receive rescue therapy at the time of study inclusion. Univariate analysis identified several associations with clinical variables. A strong association has been also found with the type of recruiting centers, with oncologic wards reporting a somewhat lower proportion of patients with BTcP (-30%) when compared with palliative centers.Patients with BTcP had a high probability of dying (OR=1.4, 95% CI: 1.1-1.7, P-value 0.006) and to change of the opioid with another for analgesic failure or for side effects (OR=1.4, 95% CI: 1.0-1.9, P-value 0.040) DISCUSSION: These findings confirm the high prevalence of BTcP and substantial undertreatment and identify a few factors associated with prevalence and prognosis.

Original languageEnglish
Pages (from-to)9-18
Number of pages10
JournalClinical Journal of Pain
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 2011

Keywords

  • breakthrough cancer pain
  • epidemiology
  • pattern of care

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

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