Abstract

PEREZ-CAJARAVILLE, J.. Quality of life and satisfaction in the elderly not cancer patient with breakthrough pain treated with sublingual fentanyl. Rev. Soc. Esp. Dolor [online]. 2016, vol.23, n.1, pp.23-31. ISSN 1134-8046.

Introduction: The prevalence of breakthrough pain (BTP) is > 55 % in non-cancer patients and around 70 % in patients with chronic pain. BTP impairs functional and emotional status of patients, resulting in a lower quality of life (QoL). It has been reported that 50 % of elderly cancer population could suffer BTP, but data on the treatment of BTP in the elderly non-cancer population are scarce. Objectives: The primary objective of this study was to assess the QoL and satisfaction of elderly non-cancer patients with BTP treated with sublingual fentanyl citrate. Secondary objectives were to evaluate the variation of pain intensity, the number of BTP episodes and the time of response to treatment, and describe the safety profile of sublingual fentanyl citrate. Methods: This was a retrospective multicenter study (n = 78) with a data collection period of 1 month. Eligible patients were > 70 years, with BTP (VAS ≥ 6) and opioids as basal treatment, who were prescribed sublingual fentanyl citrate for the treatment of BTP. Baseline data (control 0) and visits / phone controls at 3, 15 and 30 days (controls 1, 2 and 3, respectively) were performed. Results: At baseline, the mean VAS was 7.52 (SD 0.90) and the mean impairment of daily activities (CBD questionnaire) was 6.7/10 (SD 1.21). At the end of the study this value was 4.36/10 (p < 0.0001). The average score of the pain intensity category (CBD) was 2.38 lower vs. baseline (p < 0.0001). The average score on the dimensions of physical health and mental health of the SF-12 questionnaire rose significantly 2.46 and 9.27 points, respectively, vs. baseline (p = 0.0051 and p < 0.0001, respectively). The treatment was considered "good" or "excellent" by 75.32 % of patients and 92.21 % of researchers. At the end of the study patients had nearly 17 monthly BTP episodes less vs. baseline on average; this reduction was significant. The incidence of patients with BTP episode duration < 30 min significantly increased vs. baseline (80.26 vs. 46.16 %, p < 0.05). The percentage of patients taking adjuvant medication was reduced significantly during the study (64.94 vs. 75.32 % at baseline). Conclusions: The results of this study demonstrate that treatment with sublingual fentanyl citrate can help improve the QoL of elderly patients with chronic non-cancer pain and BTP, as it significantly improved all items regarding interference with daily activities (questionnaire CBD) as well as physical and mental health items of the SF-12 questionnaire. The degree of satisfaction was very high in both patients and researchers. Since the beginning of treatment there was a significant decrease vs. baseline not only in VAS scores, but in the average number of BTP episodes and in the time of response to treatment.

Keywords : Breakthrough pain; sublingual fentanyl; quality of life; satisfaction; elderly.

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