Factors influencing the use of opioids for breakthrough cancer pain: A secondary analysis of the IOPS-MS study.
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Analgesics, Opioid
/ administration & dosage
Breakthrough Pain
/ drug therapy
Cancer Pain
/ drug therapy
Female
Fentanyl
/ administration & dosage
Humans
Male
Middle Aged
Morphine
/ administration & dosage
Pain Management
Pain Measurement
Patient Satisfaction
Sex Factors
Treatment Outcome
Young Adult
Journal
European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
20
07
2018
revised:
19
09
2018
accepted:
07
11
2018
pubmed:
14
11
2018
medline:
14
6
2019
entrez:
14
11
2018
Statut:
ppublish
Résumé
Controversies exist about the choice and the doses of opioid medication in breakthrough cancer pain (BTcP). The aim was to assess factors influencing the use and the doses of opioids prescribed for BTcP. There was performed a secondary analysis of a national, multicentre study that involving 32 centres performed in patients having BTcP. Diagnosis of BTcP was based on a definite algorithm. Patients using opioids for background pain and for BTcP were selected. Average pain intensity and opioids used for background pain and BTcP, and adverse effects were assessed, as well as patient's satisfaction and the grade of mucositis. The analysis was performed in 2,771 patients. Opioid doses given for BTcP were significantly associated with those given for background pain. No relationship between adverse effects and the use and the doses of opioids used for BTcP was found. Drugs and doses were not correlated to the grade of oral mucositis. Nasal fentanyl preparations provided the fastest meaningful pain relief in comparison with other fentanyl transmucosal preparations or morphine preparations (P = 0.000). The majority of patients were satisfied with opioid medications given for BTcP. Only 2.8% of patients reported adverse effects related to opioid medication used for BTcP. Age and gender were independently associated with dosages of some fentanyl products. Opioids for BTcP were effective and safe in a large sample of cancer patients with different stages of disease. Doses of opioids proportional to doses used for background pain seem to guarantee both efficacy and safety. The use of opioids for breakthough cancer pain was effective and safe in a large sample of advanced cancer patients recruited in different stages of disease and settings. Doses of opioids proportional to opioid doses used for background analgesia, seem to guarantee both effectiveness and safety.
Sections du résumé
BACKGROUND
BACKGROUND
Controversies exist about the choice and the doses of opioid medication in breakthrough cancer pain (BTcP).
METHODS
METHODS
The aim was to assess factors influencing the use and the doses of opioids prescribed for BTcP. There was performed a secondary analysis of a national, multicentre study that involving 32 centres performed in patients having BTcP. Diagnosis of BTcP was based on a definite algorithm. Patients using opioids for background pain and for BTcP were selected. Average pain intensity and opioids used for background pain and BTcP, and adverse effects were assessed, as well as patient's satisfaction and the grade of mucositis.
RESULTS
RESULTS
The analysis was performed in 2,771 patients. Opioid doses given for BTcP were significantly associated with those given for background pain. No relationship between adverse effects and the use and the doses of opioids used for BTcP was found. Drugs and doses were not correlated to the grade of oral mucositis. Nasal fentanyl preparations provided the fastest meaningful pain relief in comparison with other fentanyl transmucosal preparations or morphine preparations (P = 0.000). The majority of patients were satisfied with opioid medications given for BTcP. Only 2.8% of patients reported adverse effects related to opioid medication used for BTcP. Age and gender were independently associated with dosages of some fentanyl products.
CONCLUSIONS
CONCLUSIONS
Opioids for BTcP were effective and safe in a large sample of cancer patients with different stages of disease. Doses of opioids proportional to doses used for background pain seem to guarantee both efficacy and safety.
SIGNIFICANCE
CONCLUSIONS
The use of opioids for breakthough cancer pain was effective and safe in a large sample of advanced cancer patients recruited in different stages of disease and settings. Doses of opioids proportional to opioid doses used for background analgesia, seem to guarantee both effectiveness and safety.
Substances chimiques
Analgesics, Opioid
0
Morphine
76I7G6D29C
Fentanyl
UF599785JZ
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
719-726Informations de copyright
© 2018 European Pain Federation - EFIC®.