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Interference with daily functioning by breakthrough pain in patients with cancer

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Abstract

Purpose

To investigate the association between quality of life (QOL) and breakthrough cancer pain (BTCP) intensity in patients who met the commonly accepted definition of BTCP.

Methods

This study was a subset analysis of a South Korean multicenter, non-interventional, cross-sectional, nationwide survey. Participants were recruited from March 2016 to December 2017. BTCP was defined as a controlled background pain of less than a numeric rating scale (NRS) of 3 and any flare-up pain intensity. Pain intensity data were collected using the Brief Pain Inventory (BPI), which includes an interference assessment of the affective and physical domains. Patients were categorized by BTCP intensity into mild (NRS 1–3), moderate (4–6), and severe (7–10) groups.

Results

Of the 969 screened patients with cancer, 679 had ≤ NRS 3 background pain, of whom 438 completed the BPI. Of these 438 patients, 40, 204, and 194 were in the mild, moderate, and severe BTCP groups, respectively. The median NRS of BTCP was 6.0 (interquartile range = 5.0–8.0). Patients with moderate-severe BTCP had significantly higher interference with daily functioning (IDF) scores than did mild BTCP patients (3.3 vs. 5.7; p < 0.01). Both domains of IDF were significantly hampered proportionally by increased BTCP intensity (p < 0.001). The median total IDF scores of the no, moderate, and severe BTCP groups were 3.3, 5.0, and 6.9, respectively. Furthermore, IDF depended on BTCP intensity, duration, and frequency (p < 0.01) but not on pain type and cause.

Conclusion

An increase in BTCP intensity is likely to result in IDF, regardless of the cause or type of BTCP.

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Funding

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1720150) and TEVA Korea. The research was supported by the Korean Cancer Study Group (KCSG) and the KCSG data center.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea

    Jung Hun Kang

  2. Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea

    Su-Jin Koh

  3. Department of Internal medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea

    So Yeon Oh

  4. Department of Preventive Medicine, Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea

    Rock Bum Kim

  5. Department of Internal Medicine, Division of Hemato-Oncology, Kosin University Gospel Hospital, Busan, Republic of Korea

    Seong Hoon Shin

  6. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yun-Gyoo Lee

  7. Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea

    Bong-Seog Kim

  8. Department of Internal Medicine, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea

    Hun Mo Ryoo

  9. Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea

    So Young Yoon

  10. Department of Internal Medicine, Chung-Ang University, Seoul, Republic of Korea

    Joung Soon Jang

  11. Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea

    Ho-Suk Oh

  12. Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea

    Young Jin Choi

  13. Department of Internal Medicine, Inha University Hospital, College of Medicine, Inha University, Incheon, Republic of Korea

    Moon Hee Lee

  14. Department of Internal Medicine, Yeungnam University, Daegu, Republic of Korea

    Kyung-Hee Lee

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  1. Jung Hun Kang
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  14. Kyung-Hee Lee
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Contributions

All authors contributed to the study conceptualization, formal analysis, investigation, original draft preparation, significant data collection, writing, reviewing, and editing. The original draft was prepared and resources provided by Jung Hun Kang and Kyung-Hee Lee. Funding was acquired by Kyung-Hee Lee. All authors read and commented on previous versions of the manuscript and approved the final version.

Corresponding author

Correspondence to Kyung-Hee Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the 33 institutional review boards and a national research committee (KCSG Protocol Review Committee) as well as with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kang, J.H., Koh, SJ., Oh, S.Y. et al. Interference with daily functioning by breakthrough pain in patients with cancer. Support Care Cancer 28, 5177–5183 (2020). https://doi.org/10.1007/s00520-020-05329-9

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  • DOI: https://doi.org/10.1007/s00520-020-05329-9

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