title: Breakthrough pain in patients referred to pain clinics: the Italian pain network retrospective study.
abstract: BACKGROUND
  Despite breakthrough pain (BTP) being one of the most severe forms of pain, there are no definitive data on its prevalence.
  
  
  METHODS
  The authors performed a retrospective survey of the prevalence of BTP in consecutive patients in four Italian pain clinics, subsequent to application of an Italian law mandating detailed clinical records on pain characteristics, treatment, and results. Mean pain intensity was assessed with a numerical rating scale from 0 to 10.
  
  
  RESULTS
  The authors analyzed records of 1,401 patients (58% women, 33.1% patients with cancer). Transient episodes of severe pain or BTP were referred by 790 patients (56.4%), including 58.2% of the men (342 of 588) and 55.1% of the women (448 of 813). Among the 464 patients with cancer, 70.3% reported daily exacerbation of pain. The mean BTP intensity was 8.31 ± 1.58 and 31.1% of patients reported experiencing three episodes per day.
  
  
  CONCLUSIONS
  Despite some limitations of the study, the authors show that transient episodes of severe pain or BTP are significantly present both in cancer and other diseases, and that many patients are not yet receiving appropriate opioid therapy. The authors need validated tools at international level for the diagnosis and treatment of BTP in patients with cancer and for transitory and patients with severe non-cancer pain. A survey at national level is needed to estimate the prevalence of BTP in different settings, to plan specific medical education.
authors.affiliation: Emergency Care, Critical Care Medicine, Pain Medicine and Anesthesiology Department, Tor Vergata Polyclinic, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gatti
authors.forename: Rocco D
authors.initials: RD
authors.lastname: Mediati
authors.forename: Carlo
authors.initials: C
authors.lastname: Reale
authors.forename: Arturo
authors.initials: A
authors.lastname: Cuomo
authors.forename: Renato
authors.initials: R
authors.lastname: Vellucci
authors.forename: Gennaro
authors.initials: G
authors.lastname: Russo
authors.forename: Amedeo
authors.initials: A
authors.lastname: Costantini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Canneti
authors.forename: Marta
authors.initials: M
authors.lastname: Luzi
authors.forename: Massimo
authors.initials: M
authors.lastname: Mammucari
authors.forename: Alessandro Fabrizio
authors.initials: AF
authors.lastname: Sabato
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D059390:Breakthrough Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications; D010146:Pain / Q000209:etiology; D018710:Pain Clinics / Q000706:statistics & numerical data*; D010147:Pain Measurement; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid