BACKGROUND Despite publicised advice and warnings, there are only scant data on the non-indicated prescription of rapid-onset preparations of fentanyl (ROF) in non-cancer pain (NCP). Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation. OBJECTIVE Initiated by the Working Group Cancer Pain and supported by the German Pain Society, a random sample survey was conducted to assess the non-indicated use of ROF. METHODS The survey addressed attendees of pain conferences who were given the option to fill in the questionnaires outside the conference or online. Primary endpoints of the structured questionnaire were quantitative and qualitative items with regard to the prescription of ROF, while secondary endpoints were opioid-induced side effects. RESULTS Obtaining a response rate of 44% (132/300) and an additional 51 online questionnaires revealed that 165 (90%) respondents had knowledge of non-indicated prescriptions or were involved in these. Of these, 65% were clinicians and 17% worked in an outpatient capacity. In all, 22% were trained pain or palliative physicians. Approximately 1205 patients were assessed indirectly. The main causes for dispensing ROF included NCP entities such as back pain (44%), neuropathic pain (33%), head or facial pain (12%), and dyspnea (5%) in cancer pain or lack of break-through pain or basic medication (44%). Sedation (32%), nausea/vomiting (31%), constipation (16%) and insufficient analgesia (31%) were the mostly commonly reported adverse effects. CONCLUSION Despite the non-ambiguous indication for ROF, physicians often demonstrate inappropriate prescription behaviour. Iatrogenic misuse of ROF should be minimized. The rates of adverse effects of ROF seems to be in line with other opioids.

中文翻译：

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Nicht-indikationsgemäßer Einsatz schnell freisetzender Fentanylzubereitungen

背景 尽管公开了建议和警告，但在非癌性疼痛 (NCP) 中使用芬太尼 (ROF) 速效制剂的非适应症处方的数据很少。由 Aries Systems Corporation 的 Editors Manager® 和 ProduXion Manager® 提供支持。目标由癌症疼痛工作组发起并得到德国疼痛协会的支持，进行了一项随机抽样调查，以评估 ROF 的非指示使用。方法 该调查针对疼痛会议的参与者，他们可以选择在会议之外或在线填写问卷。结构化问卷的主要终点是关于 ROF 处方的定量和定性项目，而次要终点是阿片类药物引起的副作用。结果 获得 44% (132/300) 的回复率和额外的 51 份在线问卷调查显示，165 (90%) 名受访者了解或参与了非指示处方。其中，65% 是临床医生，17% 在门诊工作。总共有 22% 是受过训练的疼痛或姑息治疗医师。间接评估了大约 1205 名患者。分配 ROF 的主要原因包括 NCP 实体，例如背痛 (44%)、神经性疼痛 (33%)、头部或面部疼痛 (12%) 和癌症疼痛中的呼吸困难 (5%) 或缺乏突破性疼痛或基本药物（44%）。镇静（32%）、恶心/呕吐（31%）、便秘（16%）和镇痛不足（31%）是最常报告的不良反应。结论 尽管 ROF 的指征很明确，但 医生经常表现出不适当的处方行为。应尽量减少对 ROF 的医源性滥用。ROF 的不良反应发生率似乎与其他阿片类药物一致。