Korean J Hosp Palliat Care.  2018 Mar;21(1):9-13. 10.14475/kjhpc.2018.21.1.9.

Factors Influencing Pain Medication Preference for Breakthrough Cancer Patients and Their Application to Treatments: Survey on Physicians

Affiliations
  • 1Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
  • 2Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Family Medicine, Incheon St. Mary's Hospital, Catholic University of Korea, Incheon, Korea.
  • 4Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
  • 5Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
  • 8Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. younseon@korea.ac.kr

Abstract

PURPOSE
The purpose of this study was to assess the factors influencing the rescue medication decisions for breakthrough cancer patients and evaluate treatments using the factors.
METHODS
Based on the results of an online survey conducted by the Korean Society of Hospice and Palliative Care from September 2014 through December 2014, we assessed the level of agreement on nine factors influencing rescue medication preference. The same factors were used to evaluate oral transmucosal fentanyl lozenge, oral oxycodone and intravenous morphine.
RESULTS
Agreed by 77 physicians, a rapid onset of action was the most important factor for their decision of rescue medication. Other important factors were easy administration, strong efficacy, predictable efficacy and less adverse effects. Participants agreed that intravenous morphine produced a rapid onset of action and strong and predictable efficacy and cited difficulty of administration and adverse effects as negative factors. Oral oxycodone was desirable in terms of easy administration and less adverse effects. However, its onset of action was slower than intravenous morphine. While many agreed to easy administration of oral transmucosal fentanyl lozenge, the level of agreement was low for strength and predictability of its efficacy, long-term durability and sleep improvement.
CONCLUSION
Rapid onset of action is one of the important factors that influence physicians' selection of rescue medication. Physicians' assessment of rescue medication differed by medication.

Keyword

Cancer pain; Breakthrough pain; Opioid analgesics

MeSH Terms

Analgesics, Opioid
Breakthrough Pain
Fentanyl
Hospices
Humans
Morphine
Oxycodone
Palliative Care
Analgesics, Opioid
Fentanyl
Morphine
Oxycodone
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