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Palliative Medicine
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Prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice

Giovambattista Zeppetella

Catherine A O'Doherty

Palliative Medicine, London

Silke Collins

Pallative Medicine, St Joseph's Hospice, London

A prospective survey was undertaken to determine the prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice. Of the 78 admissions surveyed, 10 patients were confused or too unwell to take part and 25 were pain-free. The remaining 43 reported 86 pains (range 1–6 per patient); of these patients, 27 (63%) had breakthrough pain and identified 52 pains (range 1–5 per patient). Breakthrough pain was classified as somatic (46%) visceral (14%), neuropathic (25%) or mixed aetiology (15%); 60% of pains were severe or excruciating. The mean number of daily breakthrough pain episodes was five (range 1–13), 54% of which occurred suddenly. Most pains (56%) were unpredictable; 75% lasted less than 30 min. These findings suggest that breakthrough pain is common in patients with non-malignant terminal disease; it is frequent, short lasting and often unpredictable, thus making treatment difficult.

Key Words: non-malignant disease • breakthrough pain • hospice

Palliative Medicine, Vol. 15, No. 3, 243-246 (2001)
DOI: 10.1191/026921601678576220
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