Prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice

• Published in: Palliative medicine 2001-05, Vol.15 (3), p.243-246
• Main Authors: Zeppetella, Giovambattista, O'Doherty, Catherine A, Collins, Silke
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analgesics, Non-Narcotic - therapeutic use; Analgesics, Opioid - therapeutic use; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Breakthrough pain; Clinical death. Palliative care. Organ gift and preservation; Delayed-Action Preparations; Drug Therapy, Combination; Hospice Care - methods; Hospices; Humans; Medical sciences; Middle Aged; Neoplasms - complications; Pain - drug therapy; Pain - epidemiology; Pain - etiology; Pain Measurement - methods; Patient Satisfaction; Prospective Studies; Terminally Ill; Terminally ill people; Treatment; Treatment Outcome
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1191/026921601678576220

A prospective survey was undertaken to determine the prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice. Of the 78 admissions surveyed, 10 patients were confused or too unwell to take part and 25 were pain-free. The remaining 43 reported 86 pains (range 1–6 per patient); of these patients, 27 (63%) had breakthrough pain and identified 52 pains (range 1–5 per patient). Breakthrough pain was classified as somatic (46%) visceral (14%), neuropathic (25%) or mixed aetiology (15%); 60% of pains were severe or excruciating. The mean number of daily breakthrough pain episodes was five (range 1–13), 54% of which occurred suddenly. Most pains (56%) were unpredictable; 75% lasted less than 30 min. These findings suggest that breakthrough pain is common in patients with non-malignant terminal disease; it is frequent, short lasting and often unpredictable, thus making treatment difficult.