Program Overview
Chronic pain of both cancer and non cancer origin is highly prevalent, yet patients often do not receive adequate pain relief. Additionally, the majority of patients with persistent pain experience breakthrough pain (BTP), which is a transitory but often excruciating pain episode occurring in the context of the background baseline pain. Suboptimal management of BTP has consequences for both patients and the healthcare system. The physical and psychosocial effects of pain can profoundly affect patients' quality of life by preventing normal activities and requiring frequent visits to healthcare providers to seek pain relief; not surprisingly, this results in substantially increased annual costs of pain-related healthcare.
Both pharmacologic and nonpharmacologic treatment strategies exist to manage BTP. In opioid-tolerant patients, immediate-release and the more recent rapid-onset opioids are available to control BTP. Confusion about the different types of opioid formulations available, combined with concerns over the risks of opioid abuse, often lead to insufficient treatment of BTP. An increased awareness of the social and economic costs associated with suboptimal BTP treatment should improve patient outcomes and help contain increasing medical costs. In particular, it is critical for healthcare specialists working in managed care settings to have a complete understanding of appropriate treatment strategies and their implications.
This educational activity highlights the medical, social, and economic impact of inadequately treated BTP. Included are an overview of BTP and the therapeutic options avail-able to treat this condition, along with the use of risk assessment tools designed to reduce the likelihood of aberrant drug-related behaviors. The costs associated with BTP and the benefits of its treatment are summarized and a framework is presented that can be used by clinicians to guide their decision-making when treating patients with BTP. Finally, a model is proposed for a population-level health economic analysis of alternate strategies for the management of BTP, and steps are delineated for accomplishing this analysis.