Browse > Article
http://dx.doi.org/10.14475/kjhpc.2018.21.1.9

Factors Influencing Pain Medication Preference for Breakthrough Cancer Patients and Their Application to Treatments: Survey on Physicians  

Shin, Jinyoung (Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine)
Shim, Jae Yong (Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine)
Seo, Min Seok (Department of Family Medicine, Incheon St. Mary's Hospital, Catholic University of Korea)
Kim, Do Yeun (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
Lee, Juneyoung (Department of Biostatistics, Korea University College of Medicine)
Hwang, In Gyu (Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine)
Baek, Sun Kyung (Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine)
Choi, Youn Seon (Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine)
Publication Information
Journal of Hospice and Palliative Care / v.21, no.1, 2018 , pp. 9-13 More about this Journal
Abstract
Purpose: The purpose of this study was to assess the factors influencing the rescue medication decisions for breakthrough cancer patients and evaluate treatments using the factors. Methods: Based on the results of an online survey conducted by the Korean Society of Hospice and Palliative Care from September 2014 through December 2014, we assessed the level of agreement on nine factors influencing rescue medication preference. The same factors were used to evaluate oral transmucosal fentanyl lozenge, oral oxycodone and intravenous morphine. Results: Agreed by 77 physicians, a rapid onset of action was the most important factor for their decision of rescue medication. Other important factors were easy administration, strong efficacy, predictable efficacy and less adverse effects. Participants agreed that intravenous morphine produced a rapid onset of action and strong and predictable efficacy and cited difficulty of administration and adverse effects as negative factors. Oral oxycodone was desirable in terms of easy administration and less adverse effects. However, its onset of action was slower than intravenous morphine. While many agreed to easy administration of oral transmucosal fentanyl lozenge, the level of agreement was low for strength and predictability of its efficacy, long-term durability and sleep improvement. Conclusion: Rapid onset of action is one of the important factors that influence physicians' selection of rescue medication. Physicians' assessment of rescue medication differed by medication.
Keywords
Cancer pain; Breakthrough pain; Opioid analgesics;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain 1999;81:129-34.   DOI
2 Caraceni A, Martini C, Zecca E, Portenoy RK, Ashby MA, Hawson G, et al. Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. Palliat Med 2004;18:177-83.   DOI
3 Davies AN, Dickman A, Reid C, Stevens AM, Zeppetella G; Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. Eur J Pain 2009;13:331-8.   DOI
4 Breuer B, Fleishman SB, Cruciani RA, Portenoy RK. Medical oncologists' attitudes and practice in cancer pain management: a national survey. J Clin Oncol 2011;29:4769-75.   DOI
5 Mercadante S, Villari P, Casuccio A. An Italian survey on the attitudes in treating breakthrough cancer pain in hospice. Support Care Cancer 2011;19:979-83.   DOI
6 Shin J, Kim DY, Lee J, Choi YS, Hwang IG, Baek SK, et al. Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey. J Cancer Educ. Epub 2016 Sep 14.
7 Zeppetella G. Impact and management of breakthrough pain in cancer. Curr Opin Support Palliat Care 2009;3:1-6.   DOI
8 Zeppetella G, Davies AN. Opioids for the management of breakthrough pain in cancer patients. Cochrane Database Syst Rev 2013;(10): CD004311. Update in: Cochrane Database Syst Rev 2015;(8):CD004311.
9 Seo MS, Shim JY, Choi YS, Kim DY, Hwang IG, Baek SK, et al. Physician's Attitude toward Treating Breakthrough Cancer Pain in Korea. Korean J Hosp Palliat Care 2017;20:18-25.   DOI
10 Shin J, Cho SJ, Lee J, Choi YS. Validation of the Korean Version of the Breakthrough Pain Assessment Tool in Cancer Patients. J Pain Symptom Manage 2017;54:361-7.   DOI
11 Zecca E, Brunelli C, Centurioni F, Manzoni A, Pigni A, Caraceni A. Fentanyl Sublingual Tablets Versus Subcutaneous Morphine for the Management of Severe Cancer Pain Episodes in Patients Receiving Opioid Treatment: A Double-Blind, Randomized, Noninferiority Trial. J Clin Oncol 2017;35:759-65.   DOI
12 Zucco F, Bonezzi C, Fornasari D. Breakthrough cancer pain (BTcP): a synthesis of taxonomy, pathogenesis, therapy, and good clinical practice in adult patients in Italy. Adv Ther 2014;31:657-82.   DOI
13 Reid CM, Gooberman-Hill R, Hanks GW. Opioid analgesics for cancer pain: symptom control for the living or comfort for the dying? A qualitative study to investigate the factors influencing the decision to accept morphine for pain caused by cancer. Ann Oncol 2008;19:44-8.   DOI
14 Kim YC, Ahn JS, Calimag MM, Chao TC, Ho KY, Tho LM, et al. Current practices in cancer pain management in Asia: a survey of patients and physicians across 10 countries. Cancer Med 2015;4:1196-204.   DOI
15 Raphael J, Ahmedzai S, Hester J, Urch C, Barrie J, Williams J, et al. Cancer pain: part 1: Pathophysiology; oncological, pharmacological, and psychological treatments: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med 2010;11:742-64.   DOI
16 Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013;41:263-306.   DOI