Improvement in patient-reported pain among patients with metastatic cancer and its association with opioid prescribing

Purpose Opioids are a mainstay of cancer pain management; however, patients with metastatic cancer are often excluded from studies, leading to a lack of evidence on whether increased prescribing (dosage and/or duration) results in improved outcomes for this population. This study aimed to investigat...

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Bibliographic Details
Published in:Supportive care in cancer 2023-07, Vol.31 (7), p.427-427, Article 427
Main Authors: Harsanyi, Hannah, Yang, Lin, Harper, Andrew, Jarada, Tamer N., Quan, May Lynn, Cheung, Winson Y., Lupichuk, Sasha, Cuthbert, Colleen, Xu, Yuan
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - therapeutic use
Cancer
Cancer patients
Care and treatment
Drug Prescriptions
Health aspects
Humans
Medicine
Medicine & Public Health
Metastasis
Narcotics
Neoplasms - complications
Neoplasms - drug therapy
Neoplasms, Second Primary
Nursing
Nursing Research
Oncology
Oncology, Experimental
Pain
Pain - drug therapy
Pain - etiology
Pain management
Pain Medicine
Patient Reported Outcome Measures
Patients
Practice Patterns, Physicians
Prescription writing
Rehabilitation Medicine
Retrospective Studies
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Summary:Purpose Opioids are a mainstay of cancer pain management; however, patients with metastatic cancer are often excluded from studies, leading to a lack of evidence on whether increased prescribing (dosage and/or duration) results in improved outcomes for this population. This study aimed to investigate whether increased opioid prescribing is associated with an improvement in patient-reported pain among patients with metastatic cancer. Patients and methods A retrospective cohort of all adult patients diagnosed with stage IV cancers, who completed at least two patient-reported outcomes (PROs) within 30 days of each other, was identified from administrative data. Opioid prescriptions were categorized by dosage level and number of prescription days. Multivariable logistic regression was used to investigate the association between opioid prescribing and clinically important improvement in pain score (≥ 1 point change on the Edmonton Symptom Assessment System). Results A total of 2169 patients were included, 770 (35.5%) of whom had active opioid prescription between PROs, with an average daily dosage of 86.1 mg of oral morphine equivalent. Active prescription was associated with improvement in pain (OR = 2.17, P  
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-023-07893-2