title: Prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice.
abstract: 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.
authors.affiliation: St Joseph's Hospice, Mare Street, London E8 45A, UK. izeppetella@stjosephshospice.org.uk
authors.forename: G
authors.initials: G
authors.lastname: Zeppetella
authors.forename: C A
authors.initials: CA
authors.lastname: O'Doherty
authors.forename: S
authors.initials: S
authors.lastname: Collins
mesh_terms: D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D019452:Terminally Ill; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations