Opioid Screening Practices in the Cancer Pain Patient.
Analgesics, Opioid
/ therapeutic use
Attitude of Health Personnel
Cancer Pain
/ drug therapy
Drug Prescriptions
/ statistics & numerical data
Female
Humans
Male
Neoplasms
/ drug therapy
Opioid-Related Disorders
/ epidemiology
Patient Compliance
Physicians
/ psychology
Practice Guidelines as Topic
Practice Patterns, Physicians'
Review Literature as Topic
Substance Abuse Detection
Surveys and Questionnaires
cancer pain
clinical practice guidelines
compliance monitoring
opioid misuse, urine drug screening
Journal
Journal of palliative medicine
ISSN: 1557-7740
Titre abrégé: J Palliat Med
Pays: United States
ID NLM: 9808462
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
pubmed:
29
8
2018
medline:
10
6
2020
entrez:
29
8
2018
Statut:
ppublish
Résumé
Despite the growing use of opioids to treat cancer pain and the probability of opioid aberrancy in the cancer setting, clinical practice guidelines (CPGs) or recommendations for active screening and monitoring of opioid compliance are lacking. To evaluate the current practices and attitudes clinicians have toward monitoring and prescribing opioids in patients with cancer; to describe the current practice of screening and monitoring opioid compliance in the cancer setting; to provide insight into the role that CPGs may have in addressing opioid aberrancy in the oncologic population. Clinicians adopt diverse clinical practices and attitudes toward opioid screening and monitoring based on cancer status. A 24-question survey that evaluated the practices and attitudes that clinicians have when screening, monitoring, and prescribing opioids in patients with active cancer and history of cancer was completed by 105 pain management physicians. A comprehensive literature review was completed, evaluating the current state of available literature regarding opioid aberrancy and opioid risk in the cancer setting and CPGs for opioid monitor compliance in the cancer setting. Multicenter, survey-based study to clinicians regarding pain management strategies in patients with active cancer, patients with a history of cancer, and patients with no history of cancer. Cancer status plays a role in the clinician's decision to screen and monitor opioid compliance in the oncologic population. For patients with active cancer, clinicians are more likely to prescribe opioids despite patient refusal for toxicology screen as well as history of substance abuse. For patients with no history of cancer, clinicians are more likely to refuse a prescription refill and eliminate opioids from treatment regimen. Based upon the results of our study and evidence from current literature provided, the authors advocate for further investigation and development of CPGs to ensure the safe and prudent screening, monitoring, and prescribing of opioids in the oncologic population.
Sections du résumé
BACKGROUND
BACKGROUND
Despite the growing use of opioids to treat cancer pain and the probability of opioid aberrancy in the cancer setting, clinical practice guidelines (CPGs) or recommendations for active screening and monitoring of opioid compliance are lacking.
OBJECTIVES
OBJECTIVE
To evaluate the current practices and attitudes clinicians have toward monitoring and prescribing opioids in patients with cancer; to describe the current practice of screening and monitoring opioid compliance in the cancer setting; to provide insight into the role that CPGs may have in addressing opioid aberrancy in the oncologic population.
HYPOTHESIS
OBJECTIVE
Clinicians adopt diverse clinical practices and attitudes toward opioid screening and monitoring based on cancer status.
DESIGN
METHODS
A 24-question survey that evaluated the practices and attitudes that clinicians have when screening, monitoring, and prescribing opioids in patients with active cancer and history of cancer was completed by 105 pain management physicians. A comprehensive literature review was completed, evaluating the current state of available literature regarding opioid aberrancy and opioid risk in the cancer setting and CPGs for opioid monitor compliance in the cancer setting.
SETTING
METHODS
Multicenter, survey-based study to clinicians regarding pain management strategies in patients with active cancer, patients with a history of cancer, and patients with no history of cancer.
RESULTS
RESULTS
Cancer status plays a role in the clinician's decision to screen and monitor opioid compliance in the oncologic population. For patients with active cancer, clinicians are more likely to prescribe opioids despite patient refusal for toxicology screen as well as history of substance abuse. For patients with no history of cancer, clinicians are more likely to refuse a prescription refill and eliminate opioids from treatment regimen.
CONCLUSIONS
CONCLUSIONS
Based upon the results of our study and evidence from current literature provided, the authors advocate for further investigation and development of CPGs to ensure the safe and prudent screening, monitoring, and prescribing of opioids in the oncologic population.
Identifiants
pubmed: 30153080
doi: 10.1089/jpm.2018.0168
pmc: PMC7476372
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
10-17Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Références
J Pain Palliat Care Pharmacother. 2014 Mar;28(1):4-9
pubmed: 24417217
Support Care Cancer. 2017 Jun;25(6):1859-1864
pubmed: 28120116
Cancer. 2017 Nov 1;123(21):4286-4293
pubmed: 28782114
QJM. 2013 Jul;106(7):603-5
pubmed: 23564652
JAMA Oncol. 2015 Apr;1(1):88-96
pubmed: 26182310
Pain Med. 2013 May;14(5):667-75
pubmed: 23631401
Ann Oncol. 2008 May;19 Suppl 2:ii119-21
pubmed: 18456748
Oncologist. 2015 Jun;20(6):692-7
pubmed: 25933929
Am J Hosp Palliat Care. 2015 Sep;32(6):654-9
pubmed: 24744398
J Clin Oncol. 2014 Jun 1;32(16):1734-8
pubmed: 24799476
CA Cancer J Clin. 2007 Nov-Dec;57(6):341-53
pubmed: 17989129
Subst Abuse Rehabil. 2016 Jun 02;7:71-9
pubmed: 27330340
Lancet Oncol. 2012 Feb;13(2):e58-68
pubmed: 22300860
Ann Oncol. 2012 Oct;23 Suppl 7:vii139-54
pubmed: 22997447
Curr Opin Support Palliat Care. 2014 Sep;8(3):273-8
pubmed: 25004173
J Palliat Med. 2008 Sep;11(7):964-8
pubmed: 18788955
Cancer. 2016 Dec 1;122(23):3732-3739
pubmed: 27509305
Cancer Invest. 2005;23(2):182-90
pubmed: 15813511
Support Care Cancer. 2014 Jul;22(7):1883-8
pubmed: 24563103
J Pain Symptom Manage. 1995 Nov;10(8):599-603
pubmed: 8594120
Ther Clin Risk Manag. 2007 Jun;3(3):381-400
pubmed: 18488078