Long-term opioid prescribing and healthcare encounters in metastatic cancer: observational population study
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View abstract on PubMed
Summary
This summary is machine-generated.Long-term opioid prescribing is common in metastatic cancer patients, especially near end-of-life. High doses and concurrent psychoactive drugs increase adverse events, necessitating targeted interventions for safer pain management.
Area Of Science
- Oncology
- Palliative Care
- Pharmacology
Background
- Opioids are crucial for cancer pain but long-term use risks are understudied in metastatic disease.
- Adverse effects of long-term opioid therapy require further investigation in this vulnerable population.
Purpose Of The Study
- To characterize long-term opioid prescribing patterns in patients with metastatic cancer.
- To examine the association between long-term opioid prescribing and opioid-related hospitalizations and emergency department visits.
Main Methods
- Retrospective cohort study of opioid-naïve patients with solid metastatic cancer in Alberta, Canada (2004-2017).
- Utilized linked administrative health data for patient identification and follow-up (≥1 year).
- Defined long-term prescribing as ≥90-day opioid supply with <30-day gap within 180 days; analyzed incidence of opioid-related healthcare encounters.
Main Results
- 23% (2521/10927) of patients received long-term opioid prescriptions, with 53% initiated in the last year of life.
- 3.4% (85/2521) of long-term recipients experienced opioid-related healthcare encounters.
- Higher opioid dosage and concurrent use of anxiolytics, benzodiazepines, antidepressants, and neuroleptics were linked to increased healthcare encounters.
Conclusions
- Long-term opioid prescribing is prevalent in metastatic cancer patients, particularly near end-of-life.
- High-dosage and concurrent psychoactive medication use are associated with increased opioid-related adverse events.
- Interventions are needed to mitigate opioid-related harms while ensuring effective pain and symptom management.
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