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Breakthrough Cancer Pain Initiative

What is the Breakthrough Cancer Pain Initiative?

The Breakthrough Cancer Pain Initiative is a nurse-driven initiative launched with the purpose of improving breakthrough pain management in cancer patients. Patient surveys demonstrate that breakthrough cancer pain is under-recognised, sub-optimally treated and therefore subject of intense patient discomfort.

Oncology nurses have an important role in identifying and managing breakthrough cancer pain and in referring difficult cases to pain specialists. The Breakthrough Cancer Pain Initiative will therefore look into the general understanding of breakthrough cancer pain amongst oncology nurses, confidence in treating these episodes, examples of best practice as well as gaps in current practice.

What does the Breakthrough Cancer Pain Initiative involve?

A European working group of oncology nurses has been formed to drive the Breakthrough Cancer Pain Initiative. The working group consists of:

• Bostjan Zavratnik, Slovakia
• Carina Rundström, Sweden
• Isolde Weisse, Germany
• Jenske Geerling, The Netherlands
• Sian Williams, United Kingdom
• Theodora Pappa, Greece

A multidisciplinary advisory group has been formed to provide expert advice based on their knowledge within palliative care in general and Breakthrough Cancer Pain in particular. The advisory group consists of:

• Prof. Yvonne Wengstrøm, Sweden
• Dr Andrew Davies, United Kingdom
• Prof. Tone Rustøen, Norway
• Prof. Stein Kaasa, Norway

Working group activities

Breakthrough cancer pain survey

A survey amongst oncology nurses in the Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Norway, Slovenia, Sweden, The Netherlands and United Kingdom has been carried out. The survey demonstrated an unmet educational need and a link between lack of training and/or assessment tools and the ability to distinguish breakthrough cancer pain from background pain and the nurses' confidence in advising patients about breakthrough cancer pain.

The survey was presented at the European Multidisciplinary Cancer Congress (EMCC) in Stockholm 24 September 2011. Download the presentation and see the webcast in the Further information section on the right.

EONS Breakthrough Cancer Pain guidelines

Utilising the framework for existing EONS guidelines, the working group is developing a set of nurse-specific evidence- and practice-based guidelines on breakthrough cancer pain management. The guidelines reflect the findings of the above-mentioned survey and are the first to address breakthrough cancer pain management from a nurse perspective.

The objective of the guidelines is to provide guidance on assessment, identification and treatment of breakthrough cancer pain, which will serve as a platform to implement nurse-specific training programs. Specific targets and aims of the guidelines are:

• Increase nurses' knowledge of specific elements of breakthrough cancer pain
• Causes for breakthrough cancer pain
• Features and symptoms of breakthrough cancer pain
• Differences between end of dose pain and transitory breakthrough cancer pain
• Consequences of breakthrough cancer pain
• Treatment measures
• Support nurses to assess and identify breakthrough cancer pain
• Encourage successful management of breakthrough cancer pain
• Update and inform nurses of the current guidelines based on previously published evidence

The breakthrough cancer pain guidelines will be published in the spring of 2012. In addition, a complementary pocket guide will be published.

The guidelines were also presented at The European Multidisciplinary Cancer Congress. Download the presentation and see the webcast in the Further information section on the right.

More information

Please contact Cohn & Wolfe, the Breakthrough Cancer Pain Initiative coordinator with any questions or to request further information:

Breakthrough Cancer Pain Initiative
Cohn & Wolfe
Rosenvaengets Allé 25
DK-2100 Copenhagen
Denmark

Mette Thorn Sørensen
Tel: +45 41 38 43 00
E-mail: mts@cohnwole.dk