High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan
Abstract Objectives Opioid availability for the palliative care of patients with advanced cancer is increasing globally. However, opioid availability remains extremely low in Japan. We investigated whether pain is appropriately controlled by low‐dose opioid prescriptions in patients with advanced ca...
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Wiley
2024-09-01
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| Series: | Neuropsychopharmacology Reports |
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| Online Access: | https://doi.org/10.1002/npr2.12448 |
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| author | Maiko Hasegawa‐Moriyama Yasuhide Morioka Shinzo Hiroi Noriyuki Naya Yura Suzuki Yuichi Koretaka Erina Hara Hiroaki Abe Kanji Uchida Masahiko Sumitani |
| author_facet | Maiko Hasegawa‐Moriyama Yasuhide Morioka Shinzo Hiroi Noriyuki Naya Yura Suzuki Yuichi Koretaka Erina Hara Hiroaki Abe Kanji Uchida Masahiko Sumitani |
| author_sort | Maiko Hasegawa‐Moriyama |
| collection | DOAJ |
| description | Abstract Objectives Opioid availability for the palliative care of patients with advanced cancer is increasing globally. However, opioid availability remains extremely low in Japan. We investigated whether pain is appropriately controlled by low‐dose opioid prescriptions in patients with advanced cancer in Japan. Methods A web‐based nationwide survey for caregivers from 2000 community comprehensive support care centers was performed in Japan to assess details about pain in the 30 days before patients died of end‐stage cancer. Separately, the data for opioid prescription doses and medical services in the 90 days before the death of patients with cancer were extracted from a health insurance claim database. Results Responses from 1034 responders were retrieved and 665 patients were included. In total, 254 patients (38.2%) complained of severe‐to‐intolerable cancer‐related pain. The median cumulative prescription dose of opioids in the 90 days before patient death was 311.0 mg by oral morphine equivalent doses. Multiple regression analyses across prefectures revealed that the proportion of patients with severe‐to‐intolerable cancer‐related pain was negatively associated with the cumulative opioid consumption expressed as morphine‐equivalent doses within 90 days before death. Conclusions The very low availability of opioids for patients with end‐stage cancer could result in high rate of severe‐to‐intolerable cancer‐related pain patients. There were several limitations in this study, and the interpretations of the findings should be carefully. However, the increase in the absolute dose of opioids could improve the palliative care framework to the pain control levels of the global standard. |
| format | Article |
| id | doaj-art-3bfc87772e324740873112bf9f87dc3c |
| institution | Kabale University |
| issn | 2574-173X |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neuropsychopharmacology Reports |
| spelling | doaj-art-3bfc87772e324740873112bf9f87dc3c2024-11-08T11:46:40ZengWileyNeuropsychopharmacology Reports2574-173X2024-09-0144350251110.1002/npr2.12448High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in JapanMaiko Hasegawa‐Moriyama0Yasuhide Morioka1Shinzo Hiroi2Noriyuki Naya3Yura Suzuki4Yuichi Koretaka5Erina Hara6Hiroaki Abe7Kanji Uchida8Masahiko Sumitani9Department of Pain and Palliative Medical Sciences, Faculty of Medicine The University of Tokyo Tokyo JapanMedical Affairs Department Shionogi & Co., Ltd. Osaka JapanMedical Affairs Department Shionogi & Co., Ltd. Osaka JapanMedical Affairs Department Shionogi & Co., Ltd. Osaka JapanData Science Department Shionogi & Co., Ltd. Osaka JapanData Science Department Shionogi & Co., Ltd. Osaka JapanDepartment of Anesthesiology and Pain Relief The University of Tokyo Hospital Tokyo JapanDepartment of Pain and Palliative Medicines The University of Tokyo Hospital Tokyo JapanDepartment of Anesthesiology and Pain Relief The University of Tokyo Hospital Tokyo JapanDepartment of Pain and Palliative Medicines The University of Tokyo Hospital Tokyo JapanAbstract Objectives Opioid availability for the palliative care of patients with advanced cancer is increasing globally. However, opioid availability remains extremely low in Japan. We investigated whether pain is appropriately controlled by low‐dose opioid prescriptions in patients with advanced cancer in Japan. Methods A web‐based nationwide survey for caregivers from 2000 community comprehensive support care centers was performed in Japan to assess details about pain in the 30 days before patients died of end‐stage cancer. Separately, the data for opioid prescription doses and medical services in the 90 days before the death of patients with cancer were extracted from a health insurance claim database. Results Responses from 1034 responders were retrieved and 665 patients were included. In total, 254 patients (38.2%) complained of severe‐to‐intolerable cancer‐related pain. The median cumulative prescription dose of opioids in the 90 days before patient death was 311.0 mg by oral morphine equivalent doses. Multiple regression analyses across prefectures revealed that the proportion of patients with severe‐to‐intolerable cancer‐related pain was negatively associated with the cumulative opioid consumption expressed as morphine‐equivalent doses within 90 days before death. Conclusions The very low availability of opioids for patients with end‐stage cancer could result in high rate of severe‐to‐intolerable cancer‐related pain patients. There were several limitations in this study, and the interpretations of the findings should be carefully. However, the increase in the absolute dose of opioids could improve the palliative care framework to the pain control levels of the global standard.https://doi.org/10.1002/npr2.12448cancer‐related painend‐stage cancer patientsopioid prescriptionpalliative care |
| spellingShingle | Maiko Hasegawa‐Moriyama Yasuhide Morioka Shinzo Hiroi Noriyuki Naya Yura Suzuki Yuichi Koretaka Erina Hara Hiroaki Abe Kanji Uchida Masahiko Sumitani High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan Neuropsychopharmacology Reports cancer‐related pain end‐stage cancer patients opioid prescription palliative care |
| title | High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan |
| title_full | High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan |
| title_fullStr | High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan |
| title_full_unstemmed | High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan |
| title_short | High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan |
| title_sort | high prevalence of severe pain is associated with low opioid availability in patients with advanced cancer combined database study and nationwide questionnaire survey in japan |
| topic | cancer‐related pain end‐stage cancer patients opioid prescription palliative care |
| url | https://doi.org/10.1002/npr2.12448 |
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