Study on dosage range evaluation opioid analgesic for breakthrough pain in cancer patients: a retrospective study.


Journal

Annals of palliative medicine
ISSN: 2224-5839
Titre abrégé: Ann Palliat Med
Pays: China
ID NLM: 101585484

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 27 02 2020
accepted: 31 08 2020
pubmed: 13 10 2020
medline: 15 5 2021
entrez: 12 10 2020
Statut: ppublish

Résumé

Breakthrough pain is an exacerbation of pain occurring in patients with chronic pain who receive opioid therapy every day. Breakthrough pain has not been routinely recognized, evaluated and treated. This study aimed to analyze the utilization of opiates analgesics, including dose regimentation, frequency of use, and the actual adverse effects in cancer patients with breakthrough pain. Data were collected by the retrospective method in the period from January to December 2017. Patients involved received opioids around the clock for treating background pain and rescue medication for treating breakthrough pain. The percentage of the rescue medication dose was calculated based on the total daily opioid dose to treat background pain. Descriptive analysis was used. From 335 visits, there were 334 of patient visit where the patient received immediate-release morphine as a rescue medication with a dose percentage between 6.67-60%, and 1 visit where the patient received codeine with a dose percentage of 16.67%. Of 335 visits, 233 patient visits received the right proportion of opioid rescue medication doses, while 102 patient visits received a greater dose proportion than the recommended dose of 5-20%. Immediate-release morphine is the most commonly prescribed analgesic to treat breakthrough pain and used at 6.67-60% of daily dose with the frequency of use between 2 to 6 times a day. There were 189 (56.42%) patient visits when the patient experienced the adverse effects of the opioid. The identified actual adverse effects are constipation, nausea, and vomiting.

Sections du résumé

BACKGROUND BACKGROUND
Breakthrough pain is an exacerbation of pain occurring in patients with chronic pain who receive opioid therapy every day. Breakthrough pain has not been routinely recognized, evaluated and treated. This study aimed to analyze the utilization of opiates analgesics, including dose regimentation, frequency of use, and the actual adverse effects in cancer patients with breakthrough pain.
METHODS METHODS
Data were collected by the retrospective method in the period from January to December 2017. Patients involved received opioids around the clock for treating background pain and rescue medication for treating breakthrough pain. The percentage of the rescue medication dose was calculated based on the total daily opioid dose to treat background pain. Descriptive analysis was used.
RESULTS RESULTS
From 335 visits, there were 334 of patient visit where the patient received immediate-release morphine as a rescue medication with a dose percentage between 6.67-60%, and 1 visit where the patient received codeine with a dose percentage of 16.67%. Of 335 visits, 233 patient visits received the right proportion of opioid rescue medication doses, while 102 patient visits received a greater dose proportion than the recommended dose of 5-20%.
CONCLUSIONS CONCLUSIONS
Immediate-release morphine is the most commonly prescribed analgesic to treat breakthrough pain and used at 6.67-60% of daily dose with the frequency of use between 2 to 6 times a day. There were 189 (56.42%) patient visits when the patient experienced the adverse effects of the opioid. The identified actual adverse effects are constipation, nausea, and vomiting.

Identifiants

pubmed: 33040560
doi: 10.21037/apm-20-492
pii: apm-20-492
doi:

Substances chimiques

Analgesics, Opioid 0
Morphine 76I7G6D29C

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1237-1243

Auteurs

Mahardian Rahmadi (M)

Clinical Pharmacy Department, Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, Indonesia; Department of Pharmacy, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia. mahardianr@ff.unair.ac.id.

Ulya Madina (U)

Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, Indonesia.

Iwan Sulianto (I)

Palliative Care and Relieved Pain Installation, Dr. Soetomo Hospital, Surabaya, East Java, Indonesia.

Elfri Padolo (E)

Pharmacy Installation, Dr. Soetomo Hospital, Surabaya, East Java, Indonesia.

Chrismawan Ardianto (C)

Clinical Pharmacy Department, Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, Indonesia.

Dinda M N Ratri (DMN)

Clinical Pharmacy Department, Faculty of Pharmacy, Universitas Airlangga, Surabaya, East Java, Indonesia; Department of Pharmacy, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia.

Agus A Fauzi (AA)

Palliative Care and Relieved Pain Installation, Dr. Soetomo Hospital, Surabaya, East Java, Indonesia; Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.

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Classifications MeSH