High dose controlled-release oxycodone in hospice care

Area of Science:

• Palliative Care
• Oncology
• Pharmacology

Background:

• Controlled-release oxycodone (OxyContin) is a common oral analgesic for terminal cancer pain.
• Limited data exists on high-dose OxyContin use in terminally ill cancer patients.
• It offers an alternative for patients intolerant to oral morphine.

Purpose of the Study:

• To investigate clinical characteristics of terminally ill hospice patients on OxyContin.
• To compare outcomes between high-dose (≥150 mg/day) and lower-dose OxyContin users.
• To assess safety, efficacy, and quality of life with varying OxyContin doses.

Main Methods:

• Retrospective chart analysis of 97 consecutive terminal cancer patients.
• Parallel group comparison of patients receiving low, moderate, and high daily OxyContin doses.
• Data collected included demographics, daily/rescue doses, and quality of life parameters.

Main Results:

• Mean daily OxyContin dose was 78.6 mg; 18.55% received high doses (mean 231.1 mg).
• Higher doses were associated with painful bony metastases (p=0.008).
• No significant differences in sleep or mood; higher doses correlated with better Karnofsky scores (OR 3.77-4.95). Survival was not dose-dependent.

Conclusions:

• High-dose OxyContin is safe and effective for terminal cancer pain management.
• Increased doses do not negatively impact survival.
• Higher OxyContin doses can improve pain relief and end-of-life care quality.