1 40 1 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource June 2021 List Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month June 2021 List URL Address <a href="http://doi.org/10.1177/02692163211008737" target="_blank" rel="noreferrer noopener">http://doi.org/​10.1177/02692163211008737</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Healthcare professionals' views of the use of oral morphine and transmucosal diamorphine in the management of paediatric breakthrough pain and the feasibility of a randomised controlled trial: A focus group study (DIPPER) Publisher An entity responsible for making the resource available Palliative Medicine. Date A point or period of time associated with an event in the lifecycle of the resource 2021 Subject The topic of the resource Breakthrough pain; diamorphine; focus groups; opioids; paediatrics; pain management; palliative care; terminal care Creator An entity primarily responsible for making the resource Jamieson L; Harrop E; Johnson M; Liossi C; Mott C; Oulton K; Skene SS; Wong ICK; Howard RF Description An account of the resource Background: Oral morphine is frequently used for breakthrough pain but the oral route is not always available and absorption is slow. Transmucosal diamorphine is administered by buccal, sublingual or intranasal routes, and rapidly absorbed. Aim(s): To explore the perspectives of healthcare professionals in the UK caring for children with life-limiting conditions concerning the assessment and management of breakthrough pain; prescribing and administration of transmucosal diamorphine compared with oral morphine; and the feasibility of a comparative clinical trial. Design/ participants: Three focus groups, analysed using a Framework approach. Doctors, nurses and pharmacists (n = 28), caring for children with life-limiting illnesses receiving palliative care, participated. Result(s): Oral morphine is frequently used for breakthrough pain across all settings; with transmucosal diamorphine largely limited to use in hospices or given by community nurses, predominantly buccally. Perceived advantages of oral morphine included confidence in its use with no requirement for specific training; disadvantages included tolerability issues, slow onset, unpredictable response and unsuitability for patients with gastrointestinal failure. Perceived advantages of transmucosal diamorphine were quick onset and easy administration; barriers included lack of licensed preparations and prescribing guidance with fears over accountability of prescribers, and potential issues with availability, preparation and palatability. Factors potentially affecting recruitment to a trial were patient suitability and onerousness for families, trial design and logistics, staff time and clinician engagement. Conclusion(s): There were perceived advantages to transmucosal diamorphine, but there is a need for access to a safe preparation. A clinical trial would be feasible provided barriers were overcome. Copyright © The Author(s) 2021. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1177/02692163211008737" target="_blank" rel="noreferrer noopener">10.1177/02692163211008737</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). 2021 Breakthrough Pain diamorphine Focus Groups Harrop E Howard RF Jamieson L Johnson M June 2021 List Liossi C Mott C Opioids Oulton K Paediatrics Pain Management Palliative Care Palliative Medicine. Skene SS Terminal Care Wong ICK