Non-steroidal anti-inflammatory drugs for pain in hospice/palliative care: an international pharmacovigilance study

Author:

McNeill RichardORCID,Boland Jason WORCID,Wilcock Andrew,Sinnarajah Aynharan,Currow David C

Abstract

ObjectivesTo describe the current, real-world use of non-steroidal anti-inflammatory drugs for pain and the associated benefits and harms.MethodsA prospective, multicentre, consecutive cohort pharmacovigilance study conducted at 14 sites across Australia, Aotearoa/New Zealand and the UK including hospital, hospice inpatient and outpatient services. Pain scores and harms were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events at baseline, 2 days and 14 days. Ad-hoc safety reporting continued until day 28.ResultsData were collected from 92 patients between March 2018 and October 2021. Most patients had cancer (91%) and were coprescribed opioids (90%). At 14 days, 83% of patients had benefit from non-steroidal anti-inflammatory drugs and 22% had harm. The most common harms were nausea (8%), vomiting (3%), acute kidney injury (3%) and non-gastrointestinal bleeding (3%); only 2% were severe and no patients ceased their non-steroidal anti-inflammatory drugs due to toxicity. Overall, 65% had benefit without harm and 3% had harm without benefit.ConclusionsMost patients benefited from non-steroidal anti-inflammatory drugs with only one in five patients experiencing tolerable harm. This suggests that short-term use of non-steroidal anti-inflammatory drugs in patients receiving palliative care is safer than previously thought and may be underused.

Publisher

BMJ

Subject

Medical–Surgical Nursing,Oncology (nursing),General Medicine,Medicine (miscellaneous)

Cited by 3 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

1. Cancer survivors and cancer pain;BJA Education;2024-09

2. New Targets for Cancer Pain Relief;Interdisciplinary Cancer Research;2024

3. Effects of Opioids on Immune and Endocrine Function in Patients with Cancer Pain;Current Treatment Options in Oncology;2023-05-05

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