Utilization of Opioids in Cancer Patients at the End of Life
Date Issued
2016
Date
2016
Author(s)
Fang, Tzu-Chiao
Abstract
Purpose This study aimed to analyze opioid utilization of Taiwan cancer patients at the end of life. Opioid prescripation rate, accumulated opioid dose and factors associated with opioid utilization were determined. Patients and Methods We conducted a cross-sectional study based on Longitudinal Health Insurance Database 2005 from National Health Insurance Research Database in Taiwan. All cancer patients who died during 2005-2007 were identified (N=152) and opioid utilization during the last three months of life were analyzed. Among patients with gastrointestinal cancer (N=78), factors associated with opioid utilization were analyzed by logistic regression, multilevel logistic regression, and generalized linear model. Results The opioid prescription rate was 78.4%.The median accumulated opioid dose was 670 mg oral morphine equivalent(OMEQ)(Standard Deviation: 3,928). Morphine was the mainly prescribed opioid (prescription rate: 69.2%, OMEQ: 156,000 mg), while tramadol was the mainly prescribed weak opioid (prescription rate: 46.7%, OMEQ: 62,805 mg).For patients with gastrointestinal cancer, opioid prescription rate was higher if patients died in 2007(OR:8.28, 95%CI=1.03-66.37) and the estimated opioid dosage was higher for patients with Charlson comorbidity index=2(estimate:2,357, P=0.037) after adjustment. Conclusion Most cancer patients in Taiwan were prescribed with opioids at the end of life. The mostly prescribed opioids was morphine, and the mostly prescribed weak opioids was tramadol. Factors associated with higher opioid utilization were patients died in 2007 and with Charlson comorbidity index=2.
Subjects
cancer patient
end of life
opioids
NHIRD
drug utilization study
SDGs
Type
thesis
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