• J Pain Symptom Manage · Nov 2021

    Review

    A systematic review of measures of breakthrough pain and their psychometric properties.

    • Christina Liossi, Katie Greenfield, Daniel E Schoth, Christine Mott, Satbir Jassal, Lorna K Fraser, Dilini Rajapakse, Richard F Howard, Margaret Johnson, Anna-Karenia Anderson, and Emily Harrop.
    • School of Psychology, University of Southampton, Highfield, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, Psychological Medicine, London , UK. Electronic address: c.liossi@soton.ac.uk.
    • J Pain Symptom Manage. 2021 Nov 1; 62 (5): 1041-1064.

    ContextBreakthrough pain (BTP) is common in cancer and other conditions yet there is a lack of validated BTP measurement tools.ObjectivesWe aimed to identify all tools assessing or characterising BTP in patients of any age with any condition, and to critically appraise their psychometric properties.MethodsThe Cochrane Library, PROSPERO, Embase, CINAHL, Medline, PsycINFO, Web of Science, Google Scholar, ProQuest, Evidence Search and OpenGrey were searched to identify all available tools used to assess BTP. A second search identified studies that had evaluated psychometric properties of tools identified in Search 1. Databases were searched from inception to November 2020. Studies were assessed using COSMIN criteria and GRADE guidelines.ResultsSearch 1 found 51 tools used to assess BTP. Search 2 found six tools that had a development study and/or a study evaluating a tool psychometric property. No tool had more than one study evaluating psychometric properties so a meta-analysis could not be conducted. Studies were of inadequate to very good quality. Only the Breakthrough Pain Assessment Tool (BAT) had sufficient content validity and at least low-quality evidence for sufficient internal consistency.ConclusionThe BAT is recommended to characterise BTP in adults with cancer; its applicability to other conditions is unknown. The remaining tools need further evaluation. Only the Breakthrough Pain Questionnaire for Children was designed for children with cancer, but no psychometric properties were evaluated. There is a need for a tool to assess and characterise BTP in children with non-cancer diagnoses and those who cannot self-report.Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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