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EAPC Algorithm for Evaluating Episodic (Breakthrough) Cancer Pain

Purpose: To evaluate a patient receiving palliative care for episodic (breakthrough) pain using the EAPC algorithm.

Description

The Working Group of the European Association for Palliative Care (EAPC) used an algorithm to help identify the different types of breakthrough pain that can occur in a patient with terminal cancer. The type and intensity of pain being experienced can help direct palliative interventions.


 

Steps in episodic (breakthrough) pain evaluation:

(1) Is there significant baseline pain, indicating inadequate pain management?

(1a) If so: Use the WHO pain ladder of increasing analgesic pain medication to provide adequate pain management, then reassess.

(2) Are there factors that can alleviate or reduce pain?

(2a) If so, educate and train the patient in ways to minimize pain.

Type of Pain

Description

Movement Related?

neuropathic

lancing, shooting, burning

can be

visceral

colicky

can be

bone/periosteal pain

pain in bones associated with movement

yes

soft tissue pain

pain with contact

can be

 


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Specialty

Objective

ICD-10