Prevalence and characteristics of breakthrough pain in opioid-treated patients with chronic noncancer pain.

Full Abstract

Breakthrough pain is well-characterized in cancer patients but not in patients with chronic noncancer pain. We recruited 228 patients with diverse types of chronic noncancer pain from 9 pain programs and administered a telephone questionnaire with a breakthrough pain assessment algorithm originally designed for cancer patients. All patients had controlled baseline pain, and 168 (74%) experienced severe to excruciating breakthrough pain. Among those with breakthrough pain, the most common syndrome was low back pain (52%), and the underlying pathophysiology was variably characterized as somatic (38%), neuropathic (18%), visceral (4%), or mixed (40%). A total of 189 different types of breakthrough pain were reported. The median number of episodes per day was 2 (range, <1 to 12). Median time to maximum intensity was 10 minutes (range, 0 to 180 minutes). Median duration of the breakthrough pain was 60 minutes (range, 1 to 720 minutes). Patients identified a precipitant for 69% of pains, and 92% of these were activity-related. Onset could never be predicted for 45% of pains and only sometimes predicted for 31% of pains. Breakthrough pain is highly prevalent and varied in this population. Further studies are warranted to clarify whether the clinical impact and therapeutic challenges posed by this phenomenon are comparable to the cancer population.

PERSPECTIVE:
This article presents results from a survey that demonstrates that breakthrough pain is highly prevalent and varied in opioid-treated patients with chronic noncancer pain. These findings will assist clinicians in assessing and managing this type of pain.

Learn Faster Today Improve your study skills

Author information

Author/s: Portenoy, Russell K (RK); Bennett, Daniel S (DS); Rauck, Richard (R); Simon, Steven (S); Taylor, Donald (D); Brennan, Michael (M); Shoemaker, Steven (S);

Affiliation: Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA. RPortenoy(-atsign-)chpnet.org

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The journal of pain : official journal of the American Pain Society (J Pain), published in United States. (Language: eng)

Reference: 2006-Aug; vol 7 (issue 8) : pp 583-91

Dates: Created 2006/08/03; Completed 2006/10/02; Revised 2007/11/15;

PMID: 16885015, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Aged, 80 and over
Analgesics, Opioid - therapeutic use
Chronic Disease
Data Collection
Female

Humans
Interviews as Topic
Male
Middle Aged
Pain - drug therapy; epidemiology; psychology
Patient Selection
Questionnaires
Telephone

Associated Chemicals: Analgesics, Opioid (0)

These are the highest related articles currently in the database:

See 100+ related articles.