A prospective, cross-sectional, multicenter, national assessment was conducted in 23 palliative care units in Italy. Those patients were recruited who were undergoing one of the following procedures as part of usual care: turning, personal hygiene care, the shifting from bed to chair, bladder catheterisation, pressure ulcer care, and subcutaneous drug administrate. The pain magitude was evaluated by Numerical Rating Scale before, during, and after the procedure.

One thousand seventy-nine eligible patients were enlisted: 49.7% were male, with mean age 78.0±11.2 years. Out of all patients, 20.9% had experienced a BTP episode within the 24 hours before enlistment. The overall prevalence of processes-induced BTP was 11.8%, and the mean magnitude score (Numeric Rating Scale) was 4.72±1.81. Notably, patients experienced a notable increase in pain intensity during all procedures. About 12.7% of patients received analgesics before undergoing any of the processes, and almost none (1.7%) received painkillers during the procedures to alleviate acute pain.

The findings of study highlight that simple daily care procedures can lead to BTP among patients with advanced disease.  Proceedings are conducted very often in palliative care, single out awareness of procedural pain control is necessary. Additional assessments on procedural pain in patients with advanced disease should be encouraged to deliver further evidence-based guidance on the use of the available medication for predictable pain flares.