Opioid use in dying patients in hospice and hospital, with and without specialist palliative care team involvement

European Journal of Cancer Care
W Brown

Abstract

Newspapers claim that patients in hospices have their opioid doses increased to a point at which doctors know that they will die. However, research has produced conflicting results about whether hospice patients receive higher doses of opioids. This study investigated the differences in opioid prescribing between cancer patients dying in hospice and hospital with and without hospital palliative care team (HPCT) involvement and non-cancer patients dying in hospital, in Dundee, UK. The only statistically significant difference in the mean dose of opioids was that the cancer patients were prescribed and received higher doses of opioids than non-cancer patients. There was no statistically significant difference in the mean dose of opioids prescribed to and given to the different groups of cancer patients dying in different settings, indicating that the claims of the press are untrue. The cancer patients dying in hospital who were not on the HPCT records more commonly received Tramadol, which may indicate a reluctance of hospital doctors to move from weak opioids to strong opioids.

References

Mar 16, 1992·The Medical Journal of Australia·P G Briggs
Jan 1, 1986·Journal of Chronic Diseases·R J GoldbergJ Hiris
May 10, 1985·JAMA : the Journal of the American Medical Association·R L KaneR Rothenberg
Mar 3, 1994·The New England Journal of Medicine·C S CleelandK J Pandya
Feb 1, 1995·Journal of Pain and Symptom Management·D S ZhukovskyM Lesser
Apr 1, 1995·Palliative Medicine·J E EllershawL C Boys
Jul 1, 1995·Palliative Medicine·D J BrooksS Ahmedzai
Apr 1, 1995·Journal of Pain and Symptom Management·M ZenzM Strumpf
Apr 1, 1997·Journal of Pain and Symptom Management·T E ElliottJ Post-White
Sep 8, 1998·The American Journal of Hospice & Palliative Care·T MoritaS Chihara
Jan 9, 2001·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·U K LammiP Kellokumpu-Lehtinen
Apr 20, 2001·Journal of Pain and Symptom Management·T MoritaS Chihara
Oct 5, 2001·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·H HinkkaU K Lammi
May 15, 2002·Journal of Pain and Symptom Management·Patsy M YatesJake M Najman
May 7, 2003·The Lancet Oncology·Nigel Sykes, Andrew Thorns
Jun 5, 2003·Journal of Pain and Symptom Management·Franco De ConnoCarla Ripamonti
Jun 26, 2003·Palliative Medicine·Jean PotterColumba Quigley
Oct 7, 2003·Palliative Medicine·Barbara JackJackie Oldham
Oct 25, 2003·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·T D WalshR Kaiko
Jan 8, 2004·JAMA : the Journal of the American Medical Association·Joan M TenoVincent Mor
Apr 2, 2004·The American Journal of Hospice & Palliative Care·Kevin Panico, Paolo Manfredi
Jul 21, 2004·Journal of the National Cancer Institute. Monographs·Deborah B McGuire
Mar 18, 2005·The Journal of Pain : Official Journal of the American Pain Society·Vincent Launay-VacherGilbert Deray

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Citations

Mar 14, 2009·Health & Social Care in the Community·Christine Brown Wilson
Dec 1, 2008·International Journal of Older People Nursing·Christine Brown Wilson
Aug 12, 2009·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Irene J HigginsonCharles Normand
Nov 20, 2014·BMC Health Services Research·Jeff RoundLouise Jones
Sep 13, 2017·International Journal of Offender Therapy and Comparative Criminology·Natalie AgaWouter Vanderplasschen
Aug 12, 2014·Aerobiologia·Dorota Myszkowska
Nov 30, 2011·Journal of Neuro-oncology·Michelangelo BartoloFrancesco Pierelli

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