Introduction: Chronic low back pain is highly prevalent in industrialized countries, where it is one of the main causes of incapacity for work. Patients with chronic low back pain in treatment with opioids often experience episodes of breakthrough pain, but prevalence and treatment preferences data are scarce.
The prevalence, characteristics, and management of breakthrough pain of patients with chronic pain of lumbar origin in Andalusia and Melilla are unknown.
Objectives: 1. Evaluation of the prevalence of breakthrough pain in patients with chronic pain secondary to chronic low back pain in Andalusia and Melilla (primary endpoint). 2. Characterization of breakthrough pain in patients with chronic pain secondary to chronic low back pain based on etiology, pathology, and other clinical characteristics. 3. Assessment of the prevalence of each of the different causes of pain. 4. Identify the possible associations between different types of breakthrough pain and sociodemographic, clinical and healthcare factors.
Materials and methods: 1,868 patients participated in the study of prevalence of breakthrough pain and 295 patients participated in the characterization study. In the prevalence study the following variables were collected: presence of breakthrough pain, sex and age. In the characterization study data were collected regarding the type and location of pain, treatment, compliance, and patient satisfaction.
Results: The prevalence of breakthrough pain in patients with chronic pain secondary to chronic low back pain is 37.5 % (95 % CI: 35.3-39.7 %), and is similar in men and women. 75% of the patients are older than 50 years. The mean value of breakthrough pain was 84.4 points in a visual analogue scale (VAS). Chronic lumbar pain is treated with a wide range of opiates.
The preferred drug of patients who control breakthrough pain with opioids is fentanyl (78.3 %) and its most common form of administration is nasal (53.2 %). The degree of compliance is high and 46.3 % of patients consider the control of their breakthrough pain very satisfactory.
Conclusions: Epidemiological data on the breakthrough pain in Andalusia and Melilla generated by this study has allowed us to know its prevalence and characteristics, as well as the preferred treatments and the degree of satisfaction of the patients.
Key words: Chronic low back pain, low back pain, breakthrough pain, opioids, fentanyl.