Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Author:

Wong Aaron K.123ORCID,Somogyi Andrew A.4ORCID,Rubio Justin5,Pham Tien Dung3ORCID,Le Brian123ORCID,Klepstad Pal6,Philip Jennifer123

Affiliation:

1. Department of Palliative Care, Peter MacCallum Cancer Centre, Melbourne 3052, Australia

2. Department of Palliative Care, The Royal Melbourne Hospital, Melbourne 3050, Australia

3. Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville 3052, Australia

4. Discipline of Pharmacology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5005, Australia

5. Florey Institute of Neuroscience & Mental Health, Parkville 3050, Australia

6. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway

Abstract

Opioid switching is a common practice of substituting one opioid for another to improve analgesia or adverse effects; however, it has limited evidence. This study aimed to examine the effectiveness of opioid switching in advanced cancer. This multi-center prospective cohort study recruited patients assessed to switch opioids (opioid switch group) or to continue ongoing opioid treatment (control group). Clinical data (demographics, opioids) and validated instruments (pain and adverse effects) were collected over two timepoints seven days apart. Descriptive analyses were utilized. Non-parametric tests were used to determine differences. Fifty-four participants were recruited (23 control group, 31 switch group). At the follow-up, opioid switching reduced pain (worst, average, and now) (p < 0.05), uncontrolled breakthrough pain (3-fold reduction, p = 0.008), and psychological distress (48% to 16%, p < 0.005). The switch group had a ≥25% reduction in the reported frequency of seven moderate-to-severe adverse effects (score ≥ 4), compared to a reduction in only one adverse effect in the control group. The control group experienced no significant pain differences at the follow-up. Opioid switching is effective at reducing pain, adverse effects, and psychological distress in a population with advanced cancer pain, to levels of satisfactory symptom control in most patients within 1 week.

Funder

Bethlehem Griffiths Research Foundation

National Health and Medical Research Council

Russell Cole Memorial Research Award

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference43 articles.

1. Update on Prevalence of Pain in Patients with Cancer: Systematic Review and Meta-Analysis;Hochstenbach;J. Pain Symptom Manag.,2016

2. Prevalence and Severity of Pain in Cancer Patients in Germany;Broemer;Front. Pain Res.,2021

3. Opioids for cancer pain—An overview of Cochrane reviews;Wiffen;Cochrane Database Syst. Rev.,2017

4. Quality of cancer pain management: An update of a systematic review of undertreatment of patients with cancer;Greco;J. Clin. Oncol.,2014

5. Cancer Pain Treatment Strategies in Patients with Cancer;Mercadante;Drugs,2022

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3