Do Patient Demographics and Performance Status Influence Opioid Dose in Cancer Pain?

Rowe, CE; Wong, AK; Buizen, L; Hawke, J; Le, B

Do Patient Demographics and Performance Status Influence Opioid Dose in Cancer Pain?

Rowe, CE Wong, AK Buizen, L Hawke, J Le, B

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: American Journal of Hospice and Palliative Care, 2023, 40, (6), pp. 607-612
Issue Date:: 2023-09-02

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Field	Value	Language
dc.contributor.author	Rowe, CE
dc.contributor.author	Wong, AK
dc.contributor.author	Buizen, L
dc.contributor.author	Hawke, J
dc.contributor.author	Le, B https://orcid.org/0000-0002-0830-4864
dc.date.accessioned	2024-01-16T05:01:50Z
dc.date.available	2024-01-16T05:01:50Z
dc.date.issued	2023-09-02
dc.identifier.citation	American Journal of Hospice and Palliative Care, 2023, 40, (6), pp. 607-612
dc.identifier.issn	1049-9091
dc.identifier.issn	1938-2715
dc.identifier.uri	http://hdl.handle.net/10453/174592
dc.description.abstract	Context: There is limited evidence on the role of objective parameters in influencing analgesic use in cancer pain management.Objective: To investigate the significance of objective parameters (age, male/female and performance status) in influencing opioid dose. Methods: We conducted a retrospective cross-sectional audit of adult inpatients with metastatic cancer at a major cancer centre from 1 January 2016 to 31 December 2018, who were prescribed slow release opioids for cancer pain on discharge. Main outcome measures were demographics (age, male/female and performance status), oral morphine equivalent daily dose (oMEDD) and adjuvant analgesic use. Results: Of the 7,747 eligible records, 215 patient records fulfilled inclusion criteria. Older patients (≥75 years) received half of the median oMEDD dose (30 mg) compared to their youngest counterparts (60 mg oMEDD in age ≤50 years) (P = .003). No significant differences were observed between oMEDD and male/female and performance status. Conclusion: Older patients are prescribed half the opioid dose compared to their younger counterparts. This highlights the importance of vigilance in opioid prescribing in the elderly in order to balance side effects with under treatment. Although no other significant relationships were observed, future studies comparing objective patient parameters with opioid prescription may uncover other at risk populations.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation.ispartof	American Journal of Hospice and Palliative Care
dc.relation.isbasedon	10.1177/10499091221123008
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Gerontology
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Morphine
dc.subject.mesh	Analgesics
dc.subject.mesh	Demography
dc.subject.mesh	Neoplasms
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Morphine
dc.subject.mesh	Analgesics
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Demography
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Practice Patterns, Physicians'
dc.subject.mesh	Morphine
dc.subject.mesh	Analgesics
dc.subject.mesh	Demography
dc.subject.mesh	Neoplasms
dc.title	Do Patient Demographics and Performance Status Influence Opioid Dose in Cancer Pain?
dc.type	Journal Article
utslib.citation.volume	40
utslib.location.activity	United States
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2024-01-16T05:01:49Z
pubs.issue	6
pubs.publication-status	Published online
pubs.volume	40
utslib.citation.issue	6

Abstract:

Context: There is limited evidence on the role of objective parameters in influencing analgesic use in cancer pain management.Objective: To investigate the significance of objective parameters (age, male/female and performance status) in influencing opioid dose. Methods: We conducted a retrospective cross-sectional audit of adult inpatients with metastatic cancer at a major cancer centre from 1 January 2016 to 31 December 2018, who were prescribed slow release opioids for cancer pain on discharge. Main outcome measures were demographics (age, male/female and performance status), oral morphine equivalent daily dose (oMEDD) and adjuvant analgesic use. Results: Of the 7,747 eligible records, 215 patient records fulfilled inclusion criteria. Older patients (≥75 years) received half of the median oMEDD dose (30 mg) compared to their youngest counterparts (60 mg oMEDD in age ≤50 years) (P = .003). No significant differences were observed between oMEDD and male/female and performance status. Conclusion: Older patients are prescribed half the opioid dose compared to their younger counterparts. This highlights the importance of vigilance in opioid prescribing in the elderly in order to balance side effects with under treatment. Although no other significant relationships were observed, future studies comparing objective patient parameters with opioid prescription may uncover other at risk populations.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/174592