Open AccessTHE END‐STAGE CANCER PATIENT: A DESCRIPTIVE ANALYSIS OF FINAL LONG‐ACTING OPIOID DOSE DISTRIBUTION AMONG HOSPICE PATIENTS
Author(s) -
Arnold R. Gammaitoni,
Endo Pharmaceuticals,
Caroline Ford,
Nancy A. Álvarez
Publication year - 2002
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1046/j.1526-4637.2002.20242.x
Subject(s) - medicine , opioid , hospice care , cancer pain , stage (stratigraphy) , descriptive statistics , distribution (mathematics) , cancer , descriptive research , palliative care , oncology , nursing , receptor , paleontology , statistics , mathematics , biology , mathematical analysis
Susannah Hall, ExcelleRx Inc., Rollin M. Gallagher, MCP Hahnemann School of Medicine, Calvin Knowlton, ExcelleRx Inc., Terri Maxwell, Thomas Jefferson University, and Douglas Weschules, ExcelleRx, Inc A long‐acting opioid is often the cornerstone of the analgesic regimen for hospice patients. The final weeks of life may be associated with increased analgesic needs related to disease progression and the effective titration of long‐acting opioids can be crucial to the enhancement of quality of life for these patients. A large range of opioid doses is reported in the literature for this population. This analysis will describe the distribution of final long‐acting opioid doses among a population of these patients. This is a retrospective analysis of all hospice patients with the primary diagnosis of cancer admitted to a North American palliative care specialty pharmacy between 4/1/00 and 3/31/01. The final opioid dose was defined as the last long‐acting opioid prescription written prior to death. Patients who were prescribed sustained release oral morphine or oxycodone or transdermal fentanyl were included in the analysis. A total of 7201 patients met the inclusion criteria for the analysis. At the time of death, 30.1% of the morphine SR patients and 24.9% of the oxycodone SR patients were prescribed oral long‐acting opioid doses that were lower than the lowest available transdermal fentanyl product. Morphine equivalent doses ≤ 120mg/day were prescribed for 67.2% of patients. Morphine equivalent doses> 300mg/day were prescribed for 9.7% of patients with 3.9% of patients prescribed doses ≥ 600mg/day. Age, but not gender, was independently associated with morphine equivalent dose. A descriptive analysis of primary cancer site within subpopulations will be presented, including those patients prescribed ≥ 600mg/day (N=280).