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Key opioid prescription concerns in cancer patients: A nationwide study
- Source :
- Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists. 54(2)
- Publication Year :
- 2016
-
Abstract
- Background Opioids are crucial in cancer pain management. We examined the nationwide prescription patterns of opioids in Taiwan cancer patients to find the potential concerns. Methods We reviewed the claims database of the National Health Insurance of Taiwan for patients diagnosed with cancer from 2003 to 2011. The use and cost of analgesics were analyzed. Opioids were classified into recommended strong opioids (morphine and transdermal fentanyl), recommended weak opioids (tramadol, buprenorphine, and codeine), and unrecommended opioids (propoxyphene, nalbuphine, and meperidine). Results We enrolled 1,424,048 patients with cancer, and ∼50% of them took analgesics. Among analgesic users, patients who used opioids increased from 48.2% in 2003 to 52.0% in 2010. Approximately 92% of the opioid use came from recommended opioids, either strong (51%) or weak opioids (41%). The ratio of the use of short-acting strong opioids to that of long-acting opioids increased from 0.41 in 2003 to 0.63 in 2011. Transdermal fentanyl accounted for > 50% of the use of strong opioids. Among weak opioids, the use of tramadol gradually increased to 71% in 2011. On average, opioids contributed to 0.79‰ of all medical expenditures and 2.94‰ of all medication costs. Conclusion The use of short-acting strong opioids increased during the study period. Instead of oral opioids, transdermal fentanyl was the most commonly used opioid among Taiwan cancer patients. The use of weak opioids, particularly tramadol, was high. These concerns should be the focus of pain management education.
- Subjects :
- Adult
Male
medicine.medical_specialty
Propoxyphene
Taiwan
Drug Prescriptions
Fentanyl
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
030212 general & internal medicine
Aged
business.industry
Codeine
General Medicine
Cancer Pain
Health Care Costs
Middle Aged
Nalbuphine
Analgesics, Opioid
Anesthesiology and Pain Medicine
Opioid
030220 oncology & carcinogenesis
Anesthesia
Female
Tramadol
Cancer pain
business
medicine.drug
Buprenorphine
Subjects
Details
- ISSN :
- 1875452X
- Volume :
- 54
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
- Accession number :
- edsair.doi.dedup.....b0a6070a9d657c317a1cba0a761b51f7