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Purpose
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 5
- TOTAL PATIENTS INCLUDED IN REVIEW = 415
- SAMPLE RANGE ACROSS STUDIES: 66–93 patients
- KEY SAMPLE CHARACTERISTICS: Mean age = 54.5 years; mean weight = 73.9 kg; mean height = 169 cm; predominantly Caucasian
Phase of Care and Clinical Applications
PHASE OF CARE: Multiple phases of care (not reported)
APPLICATIONS: Palliative care
Results
No head to head trials between products existed. FBT produced a greater improvement in PID in the first 60 minutes after dosing (66% more probable than ODT and 68% more than OTFC). ODT and OTFC showed similar benefits, and ODT had a slightly higher benefit with a 53% probability of pain relief at 60 minutes. The two agents compared with morphine sulfate immediate-release, FBT and ODT, were compared, and benefits were significant within 15 minutes after dosing.
Conclusions
FBT may be advantageous as a fentanyl product, as it showed an advantage over ODT and OTFC.
Limitations
Two of the trials compared FBT to a placebo, so more paitents received FBT. Therefore, cell sizes were not similar, resulting in an unequal comparison. Seven transmucosal immediate-release fentanyl (TIRF) studies existed. Only three were used in the comparison. Limited databases were searched.
Nursing Implications
Some TIRF products may have better efficacy compared to others. This analysis showed that FBT had an advantage. All products were shown to be superior to morphine in achieving pain relief one hour after dosing. Additional head to head comparison studies are needed.