Background: Breakthrough cancer pain (BtCP) is prevalent in cancer patients with advanced disease requiring clinical intervention. A systematic review undertaken by the authors as a part of a multiphase study, confirmed that limited peer-reviewed research has considered health professional perspectives of BtCP. 

Aim: This mixed-methods study aimed to assess clinician perspectives of BtCP, and particularly clarify (i) clinician understandings of BtCP,(ii) factors contributing to treatment decisions, and (ii) professional development.  

Methods: Participants included clinicians involved in the diagnosis and treatment of BtCP in Australia: medical oncologists, radiation oncologists, palliative medicine physicians, general practitioners who treat cancer patients, and nurses involved in the care of cancer patients. Initially, participants were invited to complete a cross-sectional survey which included nominal response option and open-ended questions aligned with study aims. After, those with interest, participated in a semi-structured interview to further explore clinician perspectives surrounding BtCP. Descriptive statistics were produced from survey data. Open-ended survey questions and interview transcripts were analysed using an inductive, grounded approach.   

Results: Findings include: (i) key characteristics which enable clinicians to establish that a patient is experiencing BtCP, (ii) factors which support and inhibit management of BtCP, and (iii) the extent of professional development received and professional development and training needs of clinicians. 

Conclusions: Diverse health professionals working to address BtCP engage with patients at different periods and contexts, thus prioritise diverse characteristics when establishing whether a patient is experiencing BtCP. Thus, barriers and facilitators to treatment and professional development requirements differ between health professionals. In part, ensuring that clinicians are aware of BtCP understandings and priorities across complementary health professions will support improved coordinated BtCP management. Professional development can assist in ensuring consistent interdisciplinary understandings of BtCP.