An observational study of oncology patients' utilization of breakthrough pain medication

The aim of this study was to determine utilization of breakthrough pain medication among a community-dwelling group of oncology patients. The subjects were recruited from patients attending the oncology outpatient department and oncology day unit. The protocol involved completion of a study-specific proforma: the information collected included demographic information (i.e., age, gender), cancer diagnosis, background cancer pain management, breakthrough pain characteristics (i.e., frequency, duration, intensity), and breakthrough cancer pain management. One hundred twenty patients participated in the study. Eighty-seven patients were experiencing breakthrough pain, although only 81 patients had been prescribed a strong opioid as breakthrough medication. Three patients had never taken the breakthrough medication, because of concerns about overdosing, concerns about tolerance, and absentmindedness about the existence of breakthrough medication. Of the remaining patients, 15 used the opioid every time they experienced breakthrough pain, whereas 63 used the opioid only some of the times they experienced breakthrough pain. The patients' impetus for taking breakthrough medication varied (e.g., onset of pain, duration of pain, intensity of pain), and the patients' reasons for not always taking breakthrough medication also varied (e.g., lack of intensity of pain, side effects of breakthrough medication, concerns about side effects of breakthrough medication). This study confirms that most patients do not take breakthrough medication every time they experience breakthrough pain. It also identified educational needs around the management of breakthrough pain for both patients and health care professionals.