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Clin Transl Oncol. 2019 Mar;21(3):380-390. doi: 10.1007/s12094-018-1925-1. Epub 2018 Aug 9.

Active study: undetected prevalence and clinical inertia in the treatment of breakthrough cancer pain (BTcP).

Author information

1
Medical Oncology Service, General University Hospital of Valencia, CIBERONC, Valencia, Spain. camps_car@gva.es.
2
Medical Oncology Service, University Hospital Virgen Macarena, Seville, Spain.
3
Degree in Medicine, Department of Health Sciences, Francisco de Vitoria University, Madrid, Spain.
4
Oncology Service, Valencian Institute of Oncology Foundation, Valencia, Spain.
5
Oncology Service, University Hospital Reina Sofía, Córdoba, Spain.
6
Medical Oncology Service, University Hospital Ramon y Cajal, IRYCIS, CIBERONC, Madrid, Spain.
7
Oncology Service, Clinical Hospital San Carlos, Madrid, Spain.
8
Oncology Service of the Jiménez Díaz Foundation, Madrid, Spain.
9
Medical Oncology Service, University Hospital La Moraleja, Madrid, Spain.
10
Medical Oncology Service, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.

Abstract

AIMS:

To prove if there is clinical inertia in the identification and treatment of episodes of breakthrough cancer pain (BTcP), comparing actual results from clinical practice with clinical oncologists' prior perception.

DESIGN:

Observational and descriptive study, using information collected by practising medical oncologists, at three moments: (a) questionnaire regarding their professional judgement of the handling of patients with BTcP in their practice, (b) cross-sectional clinical screening, to detect possible existing cases of BTcP in a representative sample of their patients, (c) retrospective self-audit of clinical case histories of patients diagnosed with BTcP to find out about how it has been handled.

PARTICIPANTS AND STUDY PERIOD:

A random sample on a state level of 108 specialists in medical oncology. 540 patients who suffer some type of cancer pain on the designated study date for each specialist (July-December 2016).

RESULTS:

The global prevalence of BTcP in the study sample covered 91.3% of the patients who were suffering some type of cancer pain. Barely 2% of the doctors surveyed suspected figures around this mark. 40.9% of the cases had not been previously detected as BTcP by their doctors. Although 90% of the patients who had previously been diagnosed with BTcP received a specific analgesic treatment for the symptoms, 42% of those patients with known BTcP were not able to control their episodes of pain.

CONCLUSIONS:

Clinical inertia is a serious problem in the handling of BTcP in medical oncology services, where it is the subject of a significantly low level of detection and treatment, despite the contrasting perception of specialists.

KEYWORDS:

Breakthrough cancer pain (BTcP); Clinical inertia; Prevalence of BTcP

PMID:
30094793
DOI:
10.1007/s12094-018-1925-1
[Indexed for MEDLINE]

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