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

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.

Oxycodone Immediate Release for Cancer Pain Management in Turkey: Maximizing Value in Opioid Analgesics

2014 ◽  
Vol 3 (4) ◽  
pp. 207-217
Author(s):  
Robert Jr ◽  
◽  
Joseph Jr. ◽  
Gianpietro Zampogna ◽  
Fuat Demirelli ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Opioid Analgesics ◽  
Immediate Release ◽  
Cancer Pain Management

scholarly journals Transdermal Fentanyl for Cancer Pain Management in Opioid-Naive Pediatric Cancer Patients

Pain Medicine ◽  
2016 ◽  
Vol 17 (7) ◽  
pp. 1329-1336 ◽  
Author(s):  
Ahmed H. Othman ◽  
Mohamad Farouk Mohamad ◽  
Heba Abdel-Razik Sayed
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Cancer Pain Management ◽  
Transdermal Fentanyl ◽  
Pediatric Cancer Patients

Physician-related barriers to cancer pain management with opioid analgesics: A systematic review

2007 ◽  
Vol 3 (4) ◽  
pp. 207 ◽  
Author(s):  
Ramune Jacobsen, MS, MPH ◽  
Per Sjøgren, MD, DMS ◽  
Claus Møldrup, PhD ◽  
Lona Christrup, PhD
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Cancer Pain ◽  
Search Strategy ◽  
Opioid Analgesics ◽  
Drug Prescribing ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Text Word ◽  
Questionnaire Surveys

Objective: The purpose of this review is to summarize the results of studies on physician-related barriers to cancer pain management with opioid analgesics.Methods: A literature search was conducted in PUBMED, using a combined text word and MeSH heading search strategy. Those articles whose full texts were not available in PUBMED were retrieved from the electronic databases of specific journals.Results: Sixty-five relevant articles, published in the period from 1986 to 2006, were identified. Physicians’ barriers to cancer pain management were studied in questionnaire surveys and in the reviews of drug prescribing documents. The results of the articles found were analyzed with respect to (a) knowledge, beliefs, concerns, problems endorsed or acknowledged by physicians treating cancer pain, (b) physicians’ skills in pain assessment, and (c) adequacy of opioid prescription.Conclusions: This review revealed mostly general and common physician-related barriers to cancer pain management: concerns about side effects to opioids, prescription of not efficient doses of opioids, and very poor prescription for the treatment of side effects from opioids. In the future, the evaluation of the influence of cultural-social-economical background, as well as the differences between the various specialists involved in the care of patients with cancer, should be explored to better understand physicians’ barriers and more effectively address them in interventional and educational programs.

Lack of Adherence With the Analgesic Regimen: A Significant Barrier to Effective Cancer Pain Management

2001 ◽  
Vol 19 (23) ◽  
pp. 4275-4279 ◽  
Author(s):  
Christine Miaskowski ◽  
Marylin J. Dodd ◽  
Claudia West ◽  
Steven M. Paul ◽  
Debu Tripathy ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Opioid Analgesics ◽  
Daily Basis ◽  
Pain Intensity Score ◽  
Cancer Pain Management ◽  
Analgesic Regimen

PURPOSE: To evaluate oncology outpatients’ level of adherence to their analgesic regimen during a 5-week period. PATIENTS AND METHODS: A random sample of 65 adult oncology outpatients with a Karnofsky performance status score of ≥ 50, an average pain intensity score of ≥ 2.5, and radiographic evidence of bone metastasis were recruited for this longitudinal study from seven outpatient settings. On a daily basis, patients rated their level of pain intensity and recorded pain medication intake. Adherence rates for opioid analgesics prescribed on an around-the-clock (ATC) and on an as-needed (PRN) basis were calculated on a weekly basis. RESULTS: Overall adherence rates for ATC opioid analgesics ranged from 84.5% to 90.8% and, for PRN analgesics, from 22.2% to 26.6%. No significant differences over time were found in either of these adherence rates. CONCLUSION: One factor that seems to contribute to ineffective cancer pain management is poor adherence to the analgesic regimen.

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