Korean J Hosp Palliat Care.  2017 Mar;20(1):18-25. 10.14475/kjhpc.2017.20.1.18.

Physician's Attitude toward Treating Breakthrough Cancer Pain in Korea

Affiliations
  • 1Department of Family Medicine, Incheon St. Mary Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
  • 2Department of Family Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.
  • 3Department of Family Medicine, Severance Hospital, Yonsei University of College of Medicine, Seoul, Korea.
  • 4Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
  • 5Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
  • 6Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
  • 8Supportive Care Center, Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
  • 9Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
  • 10Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. cglee1023@yuhs.ac

Abstract

PURPOSE
Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea.
METHODS
This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis.
RESULTS
Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications.
CONCLUSION
There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.

Keyword

Breakthrough pain; Palliative care; Opioid analgesics

MeSH Terms

Analgesics, Opioid
Breakthrough Pain
Fentanyl
Hospices
Humans
Korea*
Morphine
Oxycodone
Palliative Care
Surveys and Questionnaires
Analgesics, Opioid
Fentanyl
Morphine
Oxycodone
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