{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:57:55Z","timestamp":1764597475460,"version":"3.46.0"},"reference-count":56,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Great Ormond Street Children\u2019s Charity","award":["V5118"],"award-info":[{"award-number":["V5118"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Breakthrough pain (BTP) is commonly experienced by children and young people with life-limiting and life-threatening conditions. While over 50 tools exist for the assessment of breakthrough pain in adults, there is currently no standardised measure designed for use in paediatrics. To address this gap, the multi-phase BEACON clinical trial aims to develop the Breakthrough Pain Assessment Questionnaire (BTPAQ) for use with children and young people with life-limiting and life-threatening conditions aged 3 months to 25 years. The goal of the current study was to refine the self-report version (BTPAQ-SR) of the questionnaire through an international, sequential, electronic-Delphi process. Methods: Healthcare professionals with at least three years of clinical experience working with children and young people with life-limiting and life-threatening conditions were invited to complete an anonymous online survey. The alpha version of the BTPAQ-SR was developed from systematic reviews, qualitative interviews, and the BEACON Steering Group. It had a diagnostic algorithm (Part A) and 18 items (Part B); however, items that included multiple descriptors or options were separated and presented individually, resulting in 49 survey items being presented to participants. Participants rated the importance of all survey items to assess breakthrough pain and the frequency of presentation for a subset of 37 items. Results: Fifty-three healthcare professionals from nine different countries were recruited, the majority of whom were physicians or nurses. Of the 49 survey items, 46 (93.8%) reached the \u226570% consensus threshold for importance, and 31 (83.8%) of 37 reached consensus for frequency. In total, 42 survey items reached consensus for both importance and frequency. Conclusions: The findings from this study support the clinical need for the BTPAQ-SR, confirm its conceptual foundation, and justify its continued development. Next steps include cognitive interviews with children and young people and introduction to clinical care to assess the psychometric properties of the BTPAQ-SR, including its clinical utility, reliability, and validity.<\/jats:p>","DOI":"10.3390\/children12121627","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:03:02Z","timestamp":1764594182000},"page":"1627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishing Consensus on the Breakthrough Pain Assessment Questionnaire-Self Report (BTPAQ-SR) for Typically Developing Children and Young People (8\u201325 yrs) with Life-Limiting and Life-Threatening Conditions: An International e-Delphi Study of Expert Healthcare Professionals"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0627-6377","authenticated-orcid":false,"given":"Christina","family":"Liossi","sequence":"first","affiliation":[{"name":"Pain Research Laboratory, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, UK"},{"name":"Psychological Services, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia","family":"Turner","sequence":"additional","affiliation":[{"name":"Pain Research Laboratory, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8542-4942","authenticated-orcid":false,"given":"Anna-Karenia","family":"Anderson","sequence":"additional","affiliation":[{"name":"Royal Marsden Hospital, Sutton SM2 5PT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2480-2062","authenticated-orcid":false,"given":"Emily","family":"Harrop","sequence":"additional","affiliation":[{"name":"Helen & Douglas House Hospices, Oxford OX4 1RW, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Bailey","sequence":"additional","affiliation":[{"name":"Great North Children\u2019s Hospital, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Johnson","sequence":"additional","affiliation":[{"name":"Pain Research Laboratory, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Mott","sequence":"additional","affiliation":[{"name":"Birmingham Children\u2019s Hospital and Acorns Children\u2019s Hospice, 103 Oak Tree Lane, Selly Oak, Birmingham B29 6HZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Eric","family":"Schoth","sequence":"additional","affiliation":[{"name":"Pain Research Laboratory, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Hayden","sequence":"additional","affiliation":[{"name":"Alder Hey Children\u2019s NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilini","family":"Rajapakse","sequence":"additional","affiliation":[{"name":"Louis Dundas Centre for Oncology Outreach and Children\u2019s Palliative Care, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Renton","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-9878","authenticated-orcid":false,"given":"Bernie","family":"Carter","sequence":"additional","affiliation":[{"name":"Faculty of Health, Social Care and Medicine, Edge Hill University, St Helens Rd, Ormskirk L39 4QP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s41687-018-0061-6","article-title":"How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? 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