Prevalence of Breakthrough Cancer Pain:
Date de l'article :
2014-01-17
Auteurs :
Silvia Deandrea, MD, PhD, Oscar Corli, MD, Dario Consonni, MD, PhD,
Affiliations :
Center for the Evaluation and Research on Pain (CERP) (S.D., O.C., W.V.), IRCCS Istituto di
Ricerche Farmacologiche ‘‘Mario Negri,’’ Milan; Istituto di Statistica Medica e Biometria ‘‘G. A.
Maccacaro,’’ (S.D., M.T.G.), Universita degli Studi di Milano, Milan; Unit of Epidemiology (D.C.),
Fondazione IRCCS Ca’ GrandadOspedale Maggiore Policlinico, Milan; and Direzione Scientifica
(G.A.), IRCCS Arcispedale Santa Maria Nuova, Reggio-Emilia, Italy
Source :
Vol. 47 No. 1 January 2014 Journal of Pain and Symptom Management
Abstract :
Abstract
Context. Despite the large body of literature on breakthrough cancer pain
(BTcP), an accurate estimate of BTcP prevalence is still not available.
Objectives. To provide an estimate of BTcP prevalence and investigate
the association between different prevalence rates and possible determinants.
Methods. We conducted MEDLINE and EMBASE searches for studies
published from 1990 to 2012 reporting data on BTcP prevalence in adult cancer
populations. Pooled prevalence rates from observational studies with an
acceptable methodological quality were computed. The association between BTcP
prevalence and possible predictors was investigated using subgroup analyses and
meta-regression.
Results. Twenty-seven observational studies were identified. When quality
criteria were applied, only 19 studies were included in the pooled analysis. The
overall pooled prevalence was 59.2%, with high heterogeneity. The lowest
prevalence rates were detected in studies conducted in outpatient clinics (39.9%),
and the highest prevalence was reported in studies conducted in hospice (80.5%).
The association between BTcP prevalence and other determinants such as
publication year, age, gender, metastatic disease prevalence, or baseline pain
intensity did not reach statistical significance.
Conclusion. In the context of a large between-studies heterogeneity, more than
one in two patients with cancer pain also experiences BTcP, with some variability
according to clinical and organizational variables. J Pain Symptom Manage
2014;47:57e76. 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All
rights reserved.
Commentaires :
Ils ont faits une belle revue des douleurs subites <braektrough pain> et c'est intéressant que même l'interprétation n'est pas toujours évidente, mais l'important c'est de prévoir une entre dose de opiacé pour être certain que nos patients sont toujours soulagés même quand il y a un cahngement aigu de douleur