Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients
Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics...
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| Format: | Article |
| Language: | English |
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MDPI AG
2018-06-01
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| Series: | Cancers |
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| Online Access: | http://www.mdpi.com/2072-6694/10/6/175 |
| _version_ | 1797762881993834496 |
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| author | Sebastiano Mercadante Paolo Marchetti Arturo Cuomo Augusto Caraceni Rocco Domenico Mediati Renato Vellucci Massimo Mammucari Silvia Natoli Marzia Lazzari Mario Dauri Claudio Adile Mario Airoldi Giuseppe Azzarello Mauro Bandera Livio Blasi Giacomo Cartenì Bruno Chiurazzi Benedetta Veruska Pierpaola Costanzo Daniela Degiovanni Flavio Fusco Vittorio Guardamagna Vincenzo Iaffaioli Simeone Liguori Loredana Palermo Sergio Mameli Francesco Masedu Rodolfo Mattioli Teresita Mazzei Rita Maria Melotti Valentino Menardo Danilo Miotti Stefano Moroso Gaetano Pascoletti Stefano De Santis Remo Orsetti Alfonso Papa Sergio Ricci Elvira Scelzi Michele Sofia Giuseppe Tonini Alessandro Valle Federica Aielli on behalf of the IOPS-MS Study Group |
| author_facet | Sebastiano Mercadante Paolo Marchetti Arturo Cuomo Augusto Caraceni Rocco Domenico Mediati Renato Vellucci Massimo Mammucari Silvia Natoli Marzia Lazzari Mario Dauri Claudio Adile Mario Airoldi Giuseppe Azzarello Mauro Bandera Livio Blasi Giacomo Cartenì Bruno Chiurazzi Benedetta Veruska Pierpaola Costanzo Daniela Degiovanni Flavio Fusco Vittorio Guardamagna Vincenzo Iaffaioli Simeone Liguori Loredana Palermo Sergio Mameli Francesco Masedu Rodolfo Mattioli Teresita Mazzei Rita Maria Melotti Valentino Menardo Danilo Miotti Stefano Moroso Gaetano Pascoletti Stefano De Santis Remo Orsetti Alfonso Papa Sergio Ricci Elvira Scelzi Michele Sofia Giuseppe Tonini Alessandro Valle Federica Aielli on behalf of the IOPS-MS Study Group |
| author_sort | Sebastiano Mercadante |
| collection | DOAJ |
| description | Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics. |
| first_indexed | 2024-03-12T19:33:39Z |
| format | Article |
| id | doaj.art-95f378f0f8194c1ba6c00b1f7d918e3c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T19:33:39Z |
| publishDate | 2018-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-95f378f0f8194c1ba6c00b1f7d918e3c2023-08-02T04:18:59ZengMDPI AGCancers2072-66942018-06-0110617510.3390/cancers10060175cancers10060175Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer PatientsSebastiano Mercadante0Paolo Marchetti1Arturo Cuomo2Augusto Caraceni3Rocco Domenico Mediati4Renato Vellucci5Massimo Mammucari6Silvia Natoli7Marzia Lazzari8Mario Dauri9Claudio Adile10Mario Airoldi11Giuseppe Azzarello12Mauro Bandera13Livio Blasi14Giacomo Cartenì15Bruno Chiurazzi16Benedetta Veruska Pierpaola Costanzo17Daniela Degiovanni18Flavio Fusco19Vittorio Guardamagna20Vincenzo Iaffaioli21Simeone Liguori22Loredana Palermo23Sergio Mameli24Francesco Masedu25Rodolfo Mattioli26Teresita Mazzei27Rita Maria Melotti28Valentino Menardo29Danilo Miotti30Stefano Moroso31Gaetano Pascoletti32Stefano De Santis33Remo Orsetti34Alfonso Papa35Sergio Ricci36Elvira Scelzi37Michele Sofia38Giuseppe Tonini39Alessandro Valle40Federica Aielli41on behalf of the IOPS-MS Study Group42Anesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, 90146 Palermo, ItalyMolecular and Clinical Medicine Medical Oncology, La Sapienza University of Rome, 00155 Rome, ItalyAnesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation Pascale, 80131 Naples, ItalyPalliative Care, Pain Therapy and Rehabilitation, National Cancer Institute, IRCCS Foundation, 20133 Milan, ItalyPalliative Care and Pain Therapy Unit, Careggi Hospital, 50139 Florence, ItalyPalliative Care and Pain Therapy Unit, Careggi Hospital, 50139 Florence, ItalyPrimary Care Unit, ASL RM1, 00165 Rome, ItalyDepartment of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyAnesthesia and Intensive Care & Pain Relief and Supportive Care, La Maddalena, 90146 Palermo, ItalySecond Medical Oncology Division, Città della Salute e della Scienza Hospital of Turin, 10126 Turin, ItalyMedical Specialties Department, Oncology and Oncologic Hematology, ASL 13 Mirano, 30035 Venice, ItalyMedical Oncology Unit, Ospedale di Circolo e Fondazione Macchi Hospital, 21100 Varese, ItalyMedical Oncology Unit, ARNAS Ospedale Civico Di Cristina Benfratelli, 90127 Palermo, ItalyMedical Oncology, A.O.R.N. Cardarelli, 80131 Naples, ItalyMedical Oncology, A.O.R.N. Cardarelli, 80131 Naples, ItalyPalliative Care Unit, SAMO ONLUS, 95131 Catania, ItalyPalliative Care Unit, ASL AL, 15033 Casale Monferrato, ItalyPalliative Care Unit, Department of Primary and Community Care, ASL 3 Genovese, 16125 Genoa, ItalyPalliative Care and Pain Therapy Unit, European Oncology Institute IRCCS, 20141 Milan, ItalyAbdominal Medical Oncology, National Cancer Institute, IRCCS Foundation Pascale, 80131 Naples, ItalyPalliative Care and Pain Therapy Unit, Papa Giovanni XXIII Hospital, 24121 Bergamo, ItalyMedical Oncology Unit, National Cancer Research Center “Giovanni Paolo II”, 70124 Bari, ItalyPain Therapy Unit, “A. Businco” Hospital, ASL 8, 09134 Cagliari, ItalyDepartment of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L’Aquila, 67100 L’Aquila, ItalyMedical Oncology Unit, S. Croce Hospital, 61032 Fano-Pesaro, ItalySection of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, 50139 Florence, ItalyDepartment of Medicine and Surgery Sciences, University of Bologna, 40126 Bologna, ItalyPainTherapy, S. Croce e Carle Hospital, 12100 Cuneo, Italy, <email>vmenardo@gmail.com</email>Pain Therapy ICS Maugeri, IRCCS Foundation 27100 Pavia, ItalyMedical Oncology, Azienda Sanitaria Universitaria Integrata di Trieste, 34128 Trieste, ItalyMedical Oncology, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, ItalyPalliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, 00152 Rome, ItalyPain Medicine Unit, S. Camillo-Forlanini Hospital, 00152 Rome, ItalyPain Relief, A.O. Dei Colli, Monaldi Hospital, 80131 Naples, ItalyDivision of Medical Oncology, Department of Oncology, S. Chiara University Hospital, 56126 Pisa, ItalyMedical Oncology, Castelfranco Veneto Hospital, 31033Treviso, ItalyDepartment of Palliative Care with Hospice and Pain therapy Unit, “G. Salvini” Hospital, Garbagnate Milanese, 20024 Milan, ItalyDepartment of Medical Oncology, Campus Bio-Medico University of Rome, 00128 Rome, ItalyPalliative Care, FARO Foundation, 10133 Turin, ItalyDepartment of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyMembership of the Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS) Study Group is provided in the Acknowledgments.Background: The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Methods: Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected. Multivariate analyses were conducted to assess the correlation between BTP characteristics and the variables examined. Results: Data of 4016 patients were analysed. Average daily number of BTP episodes was 2.4, mean intensity was 7.5, and a mean duration was 43.3 min. A short onset BTP was observed in 68.9% of patients. In 30.5% of patients BTP was predictable. There were 86.0% of participants who reported a marked interference of BTP with their daily activities. Furthermore, 86.8% of patients were receiving opioids for the management of BTP. The average time to meaningful pain relief was 16.5 min and 70.9% of patients were satisfied with their BTP medications. Age, head and neck cancer, Karnofsky, background pain intensity, predictable and fast onset BTP were independently associated with the number of BTP episodes. BTP pain intensity was independently associated with background pain intensity, fast onset BTP, and Karnofsky. Neuropathic pain mechanism was independently associated with unpredictable BTP. Variables independently associated with a longer duration of BTP were age, place of visit, cancer diagnosis, disease-oriented therapy, background pain intensity and mechanism, and unpredictable BTP. Age, Karnofsky, background pain intensity, fast onset, and long duration of BTP were independently associated with interference with daily activity. Conclusions: BTP has a variable presentation depending on interdependent relationships among its different characteristics.http://www.mdpi.com/2072-6694/10/6/175breakthrough paincancerpalliative caresupportive care |
| spellingShingle | Sebastiano Mercadante Paolo Marchetti Arturo Cuomo Augusto Caraceni Rocco Domenico Mediati Renato Vellucci Massimo Mammucari Silvia Natoli Marzia Lazzari Mario Dauri Claudio Adile Mario Airoldi Giuseppe Azzarello Mauro Bandera Livio Blasi Giacomo Cartenì Bruno Chiurazzi Benedetta Veruska Pierpaola Costanzo Daniela Degiovanni Flavio Fusco Vittorio Guardamagna Vincenzo Iaffaioli Simeone Liguori Loredana Palermo Sergio Mameli Francesco Masedu Rodolfo Mattioli Teresita Mazzei Rita Maria Melotti Valentino Menardo Danilo Miotti Stefano Moroso Gaetano Pascoletti Stefano De Santis Remo Orsetti Alfonso Papa Sergio Ricci Elvira Scelzi Michele Sofia Giuseppe Tonini Alessandro Valle Federica Aielli on behalf of the IOPS-MS Study Group Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients Cancers breakthrough pain cancer palliative care supportive care |
| title | Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients |
| title_full | Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients |
| title_fullStr | Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients |
| title_full_unstemmed | Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients |
| title_short | Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients |
| title_sort | factors influencing the clinical presentation of breakthrough pain in cancer patients |
| topic | breakthrough pain cancer palliative care supportive care |
| url | http://www.mdpi.com/2072-6694/10/6/175 |
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