Use of routine and breakthrough analgesia in home care.

PURPOSE/OBJECTIVES: To describe current use of routine analgesics in home care and the treatment of breakthrough pain.

DESIGN

Descriptive, companion study.

SETTING

Homecare agencies in southern California.

SAMPLE

Convenience sample of 369 patients with cancer participating in a pain-education study.

METHODS

Data regarding breakthrough pain were derived from the homecare medical records and patient interviews.

MAIN RESEARCH VARIABLES

Analgesic medications prescribed and used for treatment of routine and breakthrough cancer pain.

FINDINGS

Results demonstrate discrepancy between recommended pain management in clinical practice guidelines and the actual practice of pain management at home. Deficiencies were found in medications prescribed as well as in actual use by patients.

CONCLUSIONS

Optimum relief of cancer pain is contingent on adequate treatment of routine and breakthrough pain, including greater use of recommended analgesics in adequate doses and clinical care consistent with clinical practice guidelines.

IMPLICATIONS FOR NURSING PRACTICE

Breakthrough pain is a common problem affecting the quality of life of patients with cancer. Improved management of breakthrough pain is contingent on accurate pain assessment, optimum use of analgesics, and patient education. Nurses should address the important topic of breakthrough pain as new analgesic drugs and methods of delivery become available.