POTENTIAL INAPPROPRIATE USE OF STRONG OPIOID ANALGESICS IN CANCER OUTPATIENTS DURING THE LAST YEAR OF LIFE IN FRANCE AND ASSOCIATED FACTORS

10.22541/au.162256051.15248929/v1 ◽

2021 ◽

Author(s):

Thanh Hang CHU ◽

Manuela Rueter ◽

Aurore Palmaro ◽

Maryse Lapeyre-Mestre

Keyword(s):

Pain Management ◽

Cancer Pain ◽

Cancer Patients ◽

Opioid Analgesics ◽

Prescribing Patterns ◽

Cancer Pain Management ◽

Factors Associated ◽

Inappropriate Use ◽

Strong Opioid ◽

Strong Opioids

Aim: A better knowledge of opioid prescribing patterns would help to identify areas of potential improvement in cancer pain management. This study aimed to identify potential inappropriate use (PIU) of strong opioid analgesics in cancer outpatients in their last year of life. Methods: A retrospective cohort of cancer patients dead between 2011 and 2014 and who were exposed as outpatient to a strong opioid analgesic in the last year of life was identified in the “Echantillon Généraliste de Bénéficiaires” (a 1/97th random sample of the French general population). Prescribing patterns of strong opioids were analyzed and PIU was defined by at least one of these criteria: overlapping prescriptions; contraindicated prescriptions; lack of laxatives; potential drug interactions; prescription in patients hospitalized for opioid-related disorders. Factors associated with PIU were investigated through a multiple logistic regression model. Results: One third of the 2,236 patients (median age 72 years (IQR: 61-82), 44.1% of women) presented a PIU (insufficient laxative prescription (19.6% of patients), insufficient background treatment with transmucosal fentanyl (14.8%), overlapping prescriptions (2.6%)). The rate of PIU significantly decreased from 37.6% (2011) to 29.8% (2014). For patients with a duration of opioid use  3 months, factors associated with PIU were fentanyl prescription (aOR=2.36; 95% CI [1.86-3.00]) and previous use of strong opioid (aOR=1.88; [1.50-2.36]) Conclusion: In France, one third of cancer patients exposed to strong opioids experienced PIU and this proportion tended to decrease over time. There is still room for progress in cancer pain management at the end of life.

Download Full-text

Do-not-resuscitate status is correlated with the prescribed use of systemic strong opioid analgesics in patients with terminal cancer: an observational study

Supportive Care in Cancer ◽

10.1007/s00520-019-04765-6 ◽

2019 ◽

Vol 27 (12) ◽

pp. 4507-4513

Author(s):

Chun-Li Wang ◽

Chia-Yen Lin ◽

Chun-Che Huang ◽

Chu-Sheng Lin ◽

Chung-Chieh Hu ◽

...

Keyword(s):

Observational Study ◽

Opioid Analgesics ◽

Terminal Cancer ◽

Do Not Resuscitate ◽

Strong Opioid

Download Full-text

Prescriptions of Strong Opioid Analgesics in Primary Care (Pharmacy Care)

Journal of Pharmacy and Pharmacology Research ◽

10.26502/jppr.0014 ◽

2019 ◽

Vol 02 (04) ◽

Author(s):

Andrea Gazova ◽

Maria Kolesarova ◽

Marek Orinak ◽

Dalibor Kolesar ◽

Jan Kyselovic

Keyword(s):

Primary Care ◽

Opioid Analgesics ◽

Strong Opioid

Download Full-text

Prevalence and associated factors of substance use among regular students in Debre Tabor University, Amhara region, Ethiopia in 2019

10.21203/rs.3.rs-57925/v1 ◽

2020 ◽

Author(s):

minale Bezie bezie ◽

Habtamu Gebrehana Belay

Keyword(s):

Substance Use ◽

Associated Factors ◽

Sampling Technique ◽

Cross Sectional Study ◽

Male Students ◽

Accounting Students ◽

Cross Sectional ◽

Inappropriate Use ◽

Debre Tabor ◽

Regular Students

Abstract Background: Substance abuse is inappropriate use of drugs or psychoactive substances in which the user consumes the substance with amount or methods which are harmful to them or others. Prevalence and associated factors of substance use among regular students in Debre Tabor University, Ethiopia 2019G.C Methods: Institutional based cross-sectional study was conducted using structured pretest and self-administered questionnaires. Systematic random sampling technique was used to collect data within sample size of 308. Result. The overall prevalence of substance use from the respondents was (62.6%). Specifically chat (11.8%), Cigarette (9%), Shisha (2.5%), Alcohol use (65.2%), and the remaining 11.8% use more than two substances This result shows that, (AOR=17.141, 95% CI=2.5-115.2770) using substance by peer friends was higher than who had no peer friends .Male students were 0.6 times more likely use substance than Females students [AOR =0.663 95%CI(0.415-1.061]. Conclusion: In this study area, prevalence of substance use among regular students was relatively high than other studies Friendly use of substances, academically fourth year students and department of accounting students were significantly associated. Key words: Substance use, prevalence, associated factors, Khat, Alcohol and Tobacco

Download Full-text

Psychiatrists are stakeholders in improving access to controlled medicines

International Psychiatry ◽

10.1192/s1749367600002794 ◽

2011 ◽

Vol 8 (4) ◽

pp. 98-100

Author(s):

Willem Scholten

Keyword(s):

Severe Pain ◽

Opioid Analgesics ◽

Drug Control ◽

Insufficient Data ◽

Need For Treatment ◽

Strong Opioid ◽

The World

Medicines made from substances that are controlled under the international drug control treaties (‘controlled medicines’) are out of reach for the majority of patients around the world. Seya et al (2011) demonstrated that 5.5 billion people (83% of the world's population) live in countries with little or no access to opioid analgesics, 250 million (4%) have moderate access and only 460 million people (7%) have adequate access. Insufficient data are available for 430 million (7%). If the need for treatment of moderate to severe pain were to be satisfied adequately, the global consumption of strong opioid analgesics would go up from 231 tonnes of morphine-equivalents to 1292 tonnes.

Download Full-text

Inappropriate use of medicines and associated factors in Brazil: an approach from a national household survey

Health Policy and Planning ◽

10.1093/heapol/czz038 ◽

2019 ◽

Vol 34 (Supplement_3) ◽

pp. iii27-iii35 ◽

Cited By ~ 1

Author(s):

Vera Lucia Luiza ◽

Luiz Villarinho Pereira Mendes ◽

Noemia Urruth Leão Tavares ◽

Andrea Damaso Bertoldi ◽

Andréia Turmina Fontanella ◽

...

Keyword(s):

Urban Population ◽

Associated Factors ◽

Household Survey ◽

Access To Medicines ◽

Free Access ◽

Inappropriate Use ◽

High Prevalence ◽

Region Of Residence ◽

National Household Survey ◽

Robust Poisson Regression

Abstract This article aims to describe the inappropriate use of medicines in the Brazilian urban population and to identify associated factors. We conducted a data analysis of a household survey carried out in Brazil in 2013–14. The sampling plan was done by clusters with representativeness of the urban population and large regions of the country, according to gender and age domains. For this analysis, we considered a sample of adults (≥20 years) who reported having chronic non-communicable diseases, medical indication for drug treatment and medicine use (n = 12 283). We evaluated the prevalence of inappropriate use in the domains: non-adherence, inappropriate use behaviour and inadequate care with medicines, all verified in the following groups of independent variables: demographic and socio-economic characteristics, health and pharmaceutical care, health status and use of medicines. Crude and adjusted prevalence ratios were obtained using robust Poisson regression. It was found 46.1% of people having at least one behaviour of inappropriate use of medicines. The worst results were found for the domain of inappropriate use behaviour, a situation of 36.6% of the users, which included unauthorized prescriber, inadequate source of information and indication of the medicines by non-authorized prescribers. The best result was found for the lack of medicines care, informed by only 4.6% of users who kept expired drugs at home. The inappropriate use of medicines was associated with gender (female), region of residence (Northeast), not visiting the doctor regularly or visiting more than one doctor, not having free access to medicines and using of five or more medicines. There was a high prevalence of inappropriate use, which was associated with both individual and health system characteristics pointing out the need to set priorities as for health education and public interventions.

Download Full-text