1. The "pain pen" for breakthrough cancer pain: a promising treatment.
- Author
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Enting RH, Mucchiano C, Oldenmenger WH, Fritzon M, Wallen A, Goslinga-van der Gaag S, Sillevis Smitt PA, and Delhaas E
- Subjects
- Adult, Aged, Aged, 80 and over, Comorbidity, Female, Humans, Injections, Subcutaneous methods, Injections, Subcutaneous statistics & numerical data, Male, Middle Aged, Neoplasms drug therapy, Netherlands epidemiology, Pilot Projects, Self Administration, Severity of Illness Index, Sweden epidemiology, Treatment Outcome, Analgesics, Opioid administration & dosage, Injections, Subcutaneous instrumentation, Neoplasms epidemiology, Pain, Intractable epidemiology, Pain, Intractable prevention & control, Palliative Care methods, Palliative Care statistics & numerical data
- Abstract
Breakthrough pain has been recognized as a challenging pain phenomenon in cancer. Oral transmucosal fentanyl citrate (OTFC) recently has been recommended as treatment, but OTFC is not widely available. Therefore, alternatives are needed. In two separate pilot studies, 58 patients were instructed to self-administer subcutaneous (SC) rescue opioids (hydromorphone (n=43), morphine (n=11), or sufentanil (n=4), using a standard injection-pen for breakthrough pain. Patients were asked to rate the overall efficacy of SC rescue opioids on a 3-point scale (not noticeable, moderate, or good). The efficacy was rated as good in 49 patients (84%, 95% CI: 73-91%), moderate in 8 patients (14%), and not noticeable in 1 patient (2%). The median dose per injection was equianalgesic to 25 mg of SC morphine (range: 4-150 mg). Twenty-nine patients (50%) were treated until death (n=26) or were on ongoing treatment (n=3). Patients were treated for a median of 6 weeks (1 day-41 months).
- Published
- 2005
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