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Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey

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Abstract

This study sought to explore the association between physician practice patterns and patient education, with a focus on breakthrough cancer pain (BTcP). A nationwide online survey was conducted by 92 Korean physicians. Thirteen questions on Korean physician’s assessment, prescription, patient education practices, and knowledge regarding BTcP were administered. Based on their responses, physicians were divided using two methods: (1) by their patient education practices, where the “education group” always explained the distinction between background pain and BTcP and the “less education group” which explained it less frequently; and (2) by their definition of BTcP, as occurring “after control of background pain” or “regardless of background pain.” We compared practice patterns using Fisher’s exact test or Student’s t test and performed multiple logistic regression analysis. The “education group” (65 physicians, 70.7 %) was more likely than the “less education group” to assess BTcP meticulously (odds ratio [OR] 17.13, 95 % confidence interval [CI] 4.98–58.94), prepare rescue medications in advance (OR 3.67, 95 % CI 1.36–9.90), and give explicit instructions regarding medications (OR 36.68, 95 % CI 5.63–239.15). Physicians who defined BTcP as occurring “after control of background pain” were more likely to explain how to take rescue medication (P < 0.05) than physicians who defined BTcP as occurring “regardless of background pain.” Korean physicians’ BTcP practice patterns may be affected by whether they consistently educate patients on the distinction between background pain and BTcP, regardless of their knowledge of the definition of BTcP.

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Acknowledgments

We would like to thank the Korean Society of Hospice and Palliative Care for providing survey data.

Author information

Authors and Affiliations

  1. Department of Family Medicine, Center for Cancer Supportive Care, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Jinyoung Shin

  2. Department of Internal Medicine, Dongguk University Ilsan Hospital, Graduate School, Dongguk University-Seoul, Goyang, South Korea

    Do Yeun Kim

  3. Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea

    Juneyoung Lee

  4. Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea

    Youn Seon Choi

  5. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea

    In Gyu Hwang

  6. Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, South Korea

    Sun Kyung Baek

  7. Department of Family Medicine, Incheon St. Mary’s Hospital, Catholic University of Korea, Incheon, South Korea

    Min Seok Seo

  8. Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea

    Jae Yong Shim

Authors
  1. Jinyoung Shin
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  2. Do Yeun Kim
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  3. Juneyoung Lee
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  4. Youn Seon Choi
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  5. In Gyu Hwang
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  6. Sun Kyung Baek
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  7. Min Seok Seo
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  8. Jae Yong Shim
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Corresponding author

Correspondence to Jae Yong Shim.

Ethics declarations

This study was approved by the institutional review board of Gangnam Severance Hospital, Yonsei University College of Medicine (IRB no. 2015-0025-001). Because this study was based on retrospective analysis of existing survey data, the ethics committee waived the informed consent requirement.

Funding

J. Lee (Department of Biostatistics, Korea University College of Medicine, Seoul, Korea) was partly supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea. The others received no specific grants from any funding agency.

Disclosures

No potential conflicts of interest relevant to this article were reported.

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Shin, J., Kim, D.Y., Lee, J. et al. Practice Patterns in Distinguishing Between Background Pain and Breakthrough Pain During Patient Education: a Korean Physician Survey. J Canc Educ 33, 284–292 (2018). https://doi.org/10.1007/s13187-016-1113-3

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  • DOI: https://doi.org/10.1007/s13187-016-1113-3

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