Medical Abbreviations: A Closer Look at BTP

Pain has been noted to be the most frequent reason patients contact their healthcare providers. It is also one of the most frustrating medical conditions for both patient and care provider. Pain is often not controlled adequately and the resulting is diminished quality of life for patient and families.

For those who experience chronic pain, there are two different types of pain. First, there is persistent pain. This is the pain that the patient notices throughout the entire day and is managed with pain medication that is taken around the clock. The second type is breakthrough pain. Breakthrough pain affects 51% to 89% of the cancer patients with controlled persistent pain.

Breakthrough pain is not controlled by the medication that a patient takes around the clock. Breakthrough pain often strikes without warning and is usually results from the same source as the persistent pain. There are three different types of breakthrough pain; incident, idiopathic and end-of-dose pain. Incidental pain occurs with activity or movement and tends to respond poorly to pharmacological intervention. Idiopathic pain occurs spontaneously and has no known associated cause. Idiopathic pain intensifies rapidly and can last longer than incidental pain. End-of-dose pain typically has a gradual onset of intensity and a longer duration. Since this type of breakthrough pain occurs typically at the end of one dose but before the next is due, it can often be eliminated by a review of medication dosing that the patient may require.

Poorly managed breakthrough pain has been noted to predict a poor outcome, lower patient satisfaction and increased use of the healthcare system. Breakthrough pain can be managed with both non-pharmacological and pharmacological treatments. Non-pharmacological treatments include; limiting activities, ice, heat, ace wraps, pacing and patient education.

Pharmacological treatment of breakthrough pain must involve medications that have a rapid onset and short duration of action. They are typically prescribed to be used as soon as breakthrough pain begins. Common drugs used to treat breakthrough pain include; fentanyl, morphine, hydromorphone, or oxycodone in immediate release form.

It is important for those who are experiencing pain to discuss options for treatment with their healthcare providers. Uncontrolled pain can prevent patients from returning to a level of functioning that they are comfortable with. There are options for pain control and patients need not feel like it is just a part of their disease process that they have to put up with.

For more information regarding breakthrough pain and how it may affect the clients you serve, contact our medical legal consulting office at Medical Jurisprudence, Inc.

References:
American Cancer Society. Breakthrough Cancer Pain: Questions and Answers Retrieved September 2007 from www.cancer.org

Burton, A.W. Outpatient Management of Breakthrough Pain Retrieved September 2007 from www.medscape.com/viewarticle/506124_print.

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