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

被引:221
作者
Caraceni, A
Martini, C
Zecca, E
Portenoy, RK
机构
[1] Natl Canc Inst, Pain Therapy & Palliat Care Unit, Neurol Unit, I-20133 Milan, Italy
[2] Beth Israel Deaconess Med Ctr, Dept Pain Med & Palliat Care, New York, NY 10003 USA
关键词
breakthrough pain; cancer pain; cancer pain classification; cancer pain syndromes; IASP; Task Force on Cancer Pain;
D O I
10.1191/0269216304pm890oa
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
引用
收藏
页码:177 / 183
页数:7
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