Evaluating patients with breakthrough pain

A task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) proposed 3 simple questions to evaluate the presence of breakthrough cancer pain.

DOES THE PATIENT HAVE BACKGROUND PAIN?

[Background pain = pain present for ≥ 12 hr / day during previous week (or would be present if not taking analgesia)]

IS THE BACKGROUND PAIN ADEQUATELY CONTROLLED?

[Adequately controlled = pain rated as “none” or “mild”, but not “moderate” or “severe” for ≥ 12 hr / day during previous week]

DOES THE PATIENT HAVE TRANSIENT EXACERBATIONS OF PAIN?

PATIENT DOES NOT HAVE BREAKTHROUGH PAIN

PATIENT HAS BREAKTHROUGH PAIN

Reference: Davies A, Dickman A, Reid C, et al. Eur J Pain. 2009;13:331-338.