{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T01:56:50Z","timestamp":1768442210105,"version":"3.49.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pain Ther"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1007\/s40122-025-00801-y","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T10:13:04Z","timestamp":1765447984000},"page":"311-324","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Patterns of Off-Label Transmucosal Immediate-Release Fentanyl Use in French General Practice: A Mixed-Methods Study Based on a Voluntary Online Survey"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5712-8887","authenticated-orcid":false,"given":"Virginie","family":"Guastella","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emeline","family":"Gueganno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9lian","family":"Bertin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Balayssac","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Authier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"801_CR1","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1001\/jama.297.3.249","volume":"297","author":"BM Kuehn","year":"2007","unstructured":"Kuehn BM. Opioid prescriptions soar: increase in legitimate use as well as abuse. JAMA. 2007;297:249\u201351. https:\/\/doi.org\/10.1001\/jama.297.3.249.","journal-title":"JAMA"},{"key":"801_CR2","doi-asserted-by":"publisher","first-page":"ES9","DOI":"10.36076\/ppj.2012\/15\/ES9","volume":"15","author":"L Manchikanti","year":"2012","unstructured":"Manchikanti L, Helm S, Fellows B, et al. Opioid epidemic in the United States. Pain Phys. 2012;15:ES9-38.","journal-title":"Pain Phys"},{"key":"801_CR3","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1056\/NEJMsa1406143","volume":"372","author":"RC Dart","year":"2015","unstructured":"Dart RC, Surratt HL, Cicero TJ, et al. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med. 2015;372:241\u20138. https:\/\/doi.org\/10.1056\/NEJMsa1406143.","journal-title":"N Engl J Med"},{"key":"801_CR4","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1302\/0301-620X.99B7.BJJ-2016-1350.R1","volume":"99-B","author":"GT Helmerhorst","year":"2017","unstructured":"Helmerhorst GT, Teunis T, Janssen SJ, et al. An epidemic of the use, misuse and overdose of opioids and deaths due to overdose, in the United States and Canada: is Europe next? Bone Jt J. 2017;99-B:856\u201364. https:\/\/doi.org\/10.1302\/0301-620X.99B7.BJJ-2016-1350.R1.","journal-title":"Bone Jt J"},{"key":"801_CR5","unstructured":"Centers for Disease Control and Prevention. U.S. opioid dispensing rate maps | drug overdose | CDC Injury Center. 2020. 2022."},{"key":"801_CR6","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1111\/bcp.13564","volume":"84","author":"K Hider-Mlynarz","year":"2018","unstructured":"Hider-Mlynarz K, Cavali\u00e9 P, Maison P. Trends in analgesic consumption in France over the last 10\u00a0years and comparison of patterns across Europe. Br J Clin Pharmacol. 2018;84:1324\u201334. https:\/\/doi.org\/10.1111\/bcp.13564.","journal-title":"Br J Clin Pharmacol"},{"key":"801_CR7","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/j.jpainsymman.2013.05.020","volume":"47","author":"G Zeppetella","year":"2014","unstructured":"Zeppetella G, Davies A, Eijgelshoven I, et al. A network meta-analysis of the efficacy of opioid analgesics for the management of breakthrough cancer pain episodes. J Pain Symptom Manag. 2014;47:772-785.e5. https:\/\/doi.org\/10.1016\/j.jpainsymman.2013.05.020.","journal-title":"J Pain Symptom Manag"},{"key":"801_CR8","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1002\/pds.5118","volume":"30","author":"D Gonz\u00e1lez-Bermejo","year":"2021","unstructured":"Gonz\u00e1lez-Bermejo D, Ray\u00f3n-Iglesias P, Rodr\u00edguez-Pascual A, et al. Drug utilization study on immediate-release fentanyl in Spain. Prevalence, incidence, and indication. Pharmacoepidemiol Drug Saf. 2021;30:371\u20138. https:\/\/doi.org\/10.1002\/pds.5118.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"801_CR9","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1016\/j.jpain.2014.08.010","volume":"15","author":"TH Stanley","year":"2014","unstructured":"Stanley TH. The fentanyl story. J Pain. 2014;15:1215\u201326. https:\/\/doi.org\/10.1016\/j.jpain.2014.08.010.","journal-title":"J Pain"},{"key":"801_CR10","doi-asserted-by":"publisher","first-page":"S90","DOI":"10.1016\/j.jpainsymman.2005.01.012","volume":"29","author":"J L\u00f6tsch","year":"2005","unstructured":"L\u00f6tsch J. Pharmacokinetic-pharmacodynamic modeling of opioids. J Pain Symptom Manag. 2005;29:S90-103. https:\/\/doi.org\/10.1016\/j.jpainsymman.2005.01.012.","journal-title":"J Pain Symptom Manag"},{"key":"801_CR11","doi-asserted-by":"publisher","first-page":"339","DOI":"10.2217\/pmt.14.32","volume":"4","author":"C Chen","year":"2014","unstructured":"Chen C, Gupta A. Clinical and pharmacokinetic considerations of novel formulations of fentanyl for breakthrough cancer pain. Pain Manag. 2014;4:339\u201350. https:\/\/doi.org\/10.2217\/pmt.14.32.","journal-title":"Pain Manag"},{"key":"801_CR12","unstructured":"Food and Drug Administration (FDA). Transmucosal immediate-release fentanyl (TIRF) medicines. FDA. 2020. Available at: https:\/\/www.fda.gov\/drugs\/information-drugclass\/transmucosal-immediate-release-fentanyl-tirf-medicines. 2022."},{"key":"801_CR13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jpainsymman.2013.02.015","volume":"47","author":"S Deandrea","year":"2014","unstructured":"Deandrea S, Corli O, Consonni D, et al. Prevalence of breakthrough cancer pain: a\u00a0systematic review and a pooled analysis of published literature. J Pain Symptom Manag. 2014;47:57\u201376. https:\/\/doi.org\/10.1016\/j.jpainsymman.2013.02.015.","journal-title":"J Pain Symptom Manag"},{"key":"801_CR14","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1191\/0269216304pm890oa","volume":"18","author":"A Caraceni","year":"2004","unstructured":"Caraceni A, Martini C, Zecca E, et al. Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. Palliat Med. 2004;18:177\u201383. https:\/\/doi.org\/10.1191\/0269216304pm890oa.","journal-title":"Palliat Med"},{"key":"801_CR15","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1001\/jamainternmed.2015.6058","volume":"176","author":"T Eguale","year":"2016","unstructured":"Eguale T, Buckeridge DL, Verma A, et al. Association of off-label drug use and adverse drug events in an adult population. JAMA Intern Med. 2016;176:55\u201363. https:\/\/doi.org\/10.1001\/jamainternmed.2015.6058.","journal-title":"JAMA Intern Med"},{"key":"801_CR16","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.therap.2019.11.002","volume":"75","author":"J Tournebize","year":"2020","unstructured":"Tournebize J, Gibaja V, Frauger E, et al. French trends in the misuse of fentanyl: From 2010\u00a0to 2015. Therapie. 2020;75:491\u2013502. https:\/\/doi.org\/10.1016\/j.therap.2019.11.002.","journal-title":"Therapie"},{"key":"801_CR17","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.jpainsymman.2022.02.016","volume":"63","author":"V Guastella","year":"2022","unstructured":"Guastella V, Delorme J, Chenaf C, et al. The prevalence of off-label prescribing of transmucosal immediate-release fentanyl in France. J Pain Symptom Manag. 2022;63:980\u20137. https:\/\/doi.org\/10.1016\/j.jpainsymman.2022.02.016.","journal-title":"J Pain Symptom Manag"},{"key":"801_CR18","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377\u201381. https:\/\/doi.org\/10.1016\/j.jbi.2008.08.010.","journal-title":"J Biomed Inform"},{"key":"801_CR19","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1097\/AJP.0000000000000450","volume":"33","author":"C Magnani","year":"2017","unstructured":"Magnani C, Giannarelli D, Casale G. Procedural pain in palliative care: is it breakthrough pain? A multicenter national prospective study to assess prevalence, intensity, and treatment of procedure-related pain in patients with advanced disease. Clin J Pain. 2017;33:707\u201314. https:\/\/doi.org\/10.1097\/AJP.0000000000000450.","journal-title":"Clin J Pain"},{"key":"801_CR20","doi-asserted-by":"publisher","first-page":"843","DOI":"10.2147\/JPR.S54788","volume":"6","author":"BC Bell","year":"2013","unstructured":"Bell BC, Butler EB. Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy. J Pain Res. 2013;6:843\u20138. https:\/\/doi.org\/10.2147\/JPR.S54788.","journal-title":"J Pain Res"},{"key":"801_CR21","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.2147\/CMAR.S179012","volume":"11","author":"W Piotrowska","year":"2019","unstructured":"Piotrowska W, Leppert W, Majkowicz M. Comparison of analgesia, adverse effects, and quality of life in cancer patients during treatment of procedural pain with intravenous morphine, fentanyl nasal spray, and fentanyl buccal tablets. Cancer Manag Res. 2019;11:1587\u2013600. https:\/\/doi.org\/10.2147\/CMAR.S179012.","journal-title":"Cancer Manag Res"},{"key":"801_CR22","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.ajem.2007.02.027","volume":"25","author":"C Rickard","year":"2007","unstructured":"Rickard C, O\u2019Meara P, McGrail M, et al. A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting. Am J Emerg Med. 2007;25:911\u20137. https:\/\/doi.org\/10.1016\/j.ajem.2007.02.027.","journal-title":"Am J Emerg Med"}],"container-title":["Pain and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40122-025-00801-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40122-025-00801-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40122-025-00801-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:24:48Z","timestamp":1768404288000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40122-025-00801-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,11]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["801"],"URL":"https:\/\/doi.org\/10.1007\/s40122-025-00801-y","relation":{},"ISSN":["2193-8237","2193-651X"],"issn-type":[{"value":"2193-8237","type":"print"},{"value":"2193-651X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,11]]},"assertion":[{"value":"4 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Virginie Guastella: consulting activities (Leurquin Mediolanum, Ethypharm, Gr\u00fcnenthal) and conferences (Ethypharm, Gr\u00fcnenthal). Emeline Gueganno: has nothing to disclose. C\u00e9lian Bertin: has nothing to disclose David Balayssac: conferences (Gr\u00fcnenthal). Bruno Pereira: has nothing to disclose. Nicolas Authier: consulting activities (UPSA, Ethypharm) and conferences (Viatris, Camurus, Bouchara Recordati, Indivior) for the benefit of the Analgesia Foundation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"The study was approved by a local ethics committee (IRB00013412, \u201cCHU de Clermont-Ferrand IRB #1,\u201d approval number 2023-CF090) and complied with French data protection regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}