Introduction:

Breakthrough pain (BTP) is a common health problem, badly known and poorly treated in spite of the advancement in its treatment. Guidelines have been published recently by Scientific Societies involved in their management in order to improve the diagnosis and treatment.

Objectives:

To know the degree of knowledge and professional agreement with Scientific Societies recommendations, the auto perception in the follow-up and the real follow-up by doctors in their outpatient clinics.

Materials and methods:

A descriptive study from professionals' opinions that were recorded in an electronic survey at two sequential times. A self-audit of clinical habits was performed between them. Professionals evaluated the level of agreement and the application of 12 recommendations from the guidelines in five patients with BPT in their outpatient clinics.

Results:

A total of 202 doctors from breakthrough pain units and palliative care participated in the study, at a national level; the mean of professional experience was 11.9 years. Mean age was 47.9 years and 45 % were women. Recommendations' document was known by 86.6 %. Recommendations with lower degree of agreement or considered less followed-up by professionals were: 1. Recommendation related to the patient's follow-up during medication titration process: 78.7 % and 18.3 % of surveyed were totally or partially agree with it while 59.4 % always applied it. 2. Recommendation related to prevention of opioid side effects from the beginning of the treatment: 56.4 % and 18.8 % of surveyed were totally or partially agree with it while 66.3 % always applied it. 3. Recommendation related to the need of the patient of receiving opioids for baseline pain: 76.7 % and 35.6 % of surveyed were totally or partially agree with it while 66.8 % always applied it.

After clinical records self-audit, recommendations regarding patients' follow-up and prevention of side effects were not applied between 15 and 20 % of the times, in line to previous perceptions from specialists. However, recommendation related to the use of opioids for baseline pain disclosed a lower breach (7 %) than perceived (33.2 %).

Conclusions:

Professionals from Pain Units and Palliative Care Units have a realistic and accurate perception of the quality of their job in patients with breakthrough pain as well as the improvement areas in their daily job regarding the follow-up and application of recommendations based in scientific evidence.

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