Opioid Prescriptions Underprescribed for Severe Pain in Elderly Patients with Cancer
(ChemotherapyAdvisor) – A Canadian study has identified factors associated with opioid prescriptions for severe pain in the elderly: younger age, male sex, comorbid illness, type of cancer, and assessment at home, results of a study in the Journal of Clinical Oncology published online February 27 has found.
The investigators measured opioid prescription rates in patients older than 65 years of age at the time of outpatient pain assessment and, for those with severe pain, evaluated factors associated with receiving prescriptions for opioids. Pain score categories were 0, 1 to 3 (mild), 4 to 6 (moderate), and 7 to 10 (severe). Multiple health databases were linked to determine what proportion of patients were prescribed an opioid with 7 days after or 30 days prior to the date of assessment. They also examined what factors were associated with opioid prescriptions for patients with severe pain.
Opioid prescriptions increased proportionally with pain severity, with 10% of patients with no pain, 24% with mild pain, 45% with moderate pain, and 67% with severe pain receiving a prescription. For those with severe pain, 41% filled a prescription for an opioid within 7 days of assessment and 26% had an existing opioid prescription <30 days before assessment; 33% were not prescribed opioids.
The authors concluded that the proportion of patients without a prescription for opioids “seems high,” necessitating greater symptom screening “to optimize management of cancer-related pain.”