Journal of Cancer Education

, Volume 33, Issue 2, pp 284–292 | Cite as

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

  • Jinyoung Shin
  • Do Yeun Kim
  • Juneyoung Lee
  • Youn Seon Choi
  • In Gyu Hwang
  • Sun Kyung Baek
  • Min Seok Seo
  • Jae Yong Shim


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.


Breakthrough pain Physician practice patterns Health knowledge 



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

Compliance with Ethical Standards

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.


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.


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


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Copyright information

© American Association for Cancer Education 2016

Authors and Affiliations

  • Jinyoung Shin
    • 1
  • Do Yeun Kim
    • 2
  • Juneyoung Lee
    • 3
  • Youn Seon Choi
    • 4
  • In Gyu Hwang
    • 5
  • Sun Kyung Baek
    • 6
  • Min Seok Seo
    • 7
  • Jae Yong Shim
    • 8
  1. 1.Department of Family Medicine, Center for Cancer Supportive Care, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Internal Medicine, Dongguk University Ilsan Hospital, Graduate SchoolDongguk University-SeoulGoyangSouth Korea
  3. 3.Department of BiostatisticsKorea University College of MedicineSeoulSouth Korea
  4. 4.Department of Family Medicine, Korea University Guro HospitalKorea University College of MedicineSeoulSouth Korea
  5. 5.Department of Internal MedicineChung-Ang University College of MedicineSeoulSouth Korea
  6. 6.Department of Internal Medicine, Kyung Hee University HospitalKyung Hee University School of MedicineSeoulSouth Korea
  7. 7.Department of Family Medicine, Incheon St. Mary’s HospitalCatholic University of KoreaIncheonSouth Korea
  8. 8.Department of Family Medicine, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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