The following is a summary of “A rapid systematic review of breakthrough pain definitions and descriptions,” published in the December 2023 issue of Pain by Greenfield et al.
Despite 30 years of study, breakthrough pain in life-limiting and end-of-life situations remains a nebulous beast, lacking a clear-cut definition and consistent features.
Researchers conducted a retrospective study, building on Haugen et al.’s 2010 work to map the diverse landscape of breakthrough pain definitions and patient/provider experiences.
They followed Cochrane Rapid Review Methods Group guidelines for this swift systematic review. The protocol is available on PROSPERO (CRD42019155583). CINAHL, MEDLINE, PsycINFO, and the Web of Science from each database’s inception were searched (August 26, 2022) for breakthrough pain terms.
The results showed 65 studies incorporating data on breakthrough pain definitions, descriptions, or classifications from patients (n = 30), clinicians (n = 6), and experts (n = 29), with no caregiver data. A majority of experts proposed that breakthrough pain manifested as a sudden, severe, brief episode in patients with well-managed mild-moderate background pain. Nevertheless, definitions varied and needed more consensus. Pain characteristics were generally consistent, though temporal factors showed wide variation. Breakthrough pain was classified by experts into nociceptive, neuropathic, visceral, somatic, or mixed types, often linked with depression, anxiety, and disruptions in daily life.
Investigators concluded that the definition of breakthrough pain remains elusive, although comprehensive data mining, further research, and clinical action are required.
Source: journals.sagepub.com/doi/10.1177/20494637231208093
