What is breakthrough pain, or "BTP"?
If you have moderate to severe pain that lasts 12
hours or more per day, it is called persistent pain, and your doctor
can give you a longer-acting medication that should last up to 12
hours or more.
Unfortunately, up to 86% of patients already receiving
longer-acting pain medication also experience sudden flare-ups of
pain that "break through" the medication they are taking.1
This is called "breakthrough pain," or "BTP."
Why is it important to treat BTP?
Breakthrough pain strikes quickly and without warning
in many cases.2 Untreated breakthrough pain can decrease your quality
of life by negatively affecting your mood and interactions with
others, and by limiting your daily activities.3
The ideal medication for breakthrough pain would begin
to work quickly and would last about as long as a typical breakthrough
pain episode.4
How is medicine for BTP different from the medicine
I already take for my persistent pain?
The medicine that you are already taking for your
persistent pain is called "longer-acting," "sustained-release,"
or "around-the-clock" medicine. Some examples of longer-acting
medicines are pills that are taken every 8 to 12 hours or a skin
patch that is worn for several days.
The medicines required for breakthrough pain are called
"shorter-acting," "supplemental," or "rescue"
medicines.
Do I have BTP?
Some patients find it difficult to bring up the topic
of pain. They assume the pain medication they're already receiving
is all that's available. Or they think they'll distract their doctor
from their therapy for their disease or condition. Neither is true.
Pain is now considered a separate medical condition that requires
treatment separate from treatment of a disease or condition. So
to make sure you're getting the pain control you deserve, talk to
your doctor. The pain self-assessment form for patients can help
you do this. If you print it out now and fill in your answers, it
will be ready for your next appointment.
References:
1. Fine PG, Busch MA. Characterization of breakthrough pain by hospice
patients and their caregivers. J Pain Symptom Manage. 1998;16:179-183.
2. Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence
and characteristics. Pain. 1990;41:273-281.
3. Simmonds MA. Management of breakthrough pain due to cancer. Oncology.
1999;13:1103-1108.
4. Chandler S. Oral transmucosal fentanyl citrate: a new treatment
for breakthrough pain. Am J Hosp Palliat Care. 1999;16:489-491.
