Assessment

Successful management of breakthrough pain depends on adequate assessment and adequate re-assessment. The assessment of pain primarily depends on basic clinical skills, that is, taking a detailed history and performing a thorough examination. Inadequate assessment may lead to ineffective or even inappropriate treatment. The objectives of assessment are to determine the aetiology and pathophysiology of the pain, and factors that indicate or contraindicate particular treatments. It is important to differentiate patients with uncontrolled background pain experiencing transient exacerbations of that pain, from patients with controlled background pain experiencing episodes of breakthrough pain. Inadequate reassessment may lead to the continuance of ineffective or inappropriate treatment. A number of different tools have been developed for the assessment of cancer-related pain. Those focusing on breakthrough pain include: the Breakthrough Pain Questionnaire, the Alberta Breakthrough Pain Assessment Tool, and the Breakthrough Pain Assessment Tool.