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dc.contributor.authorZiegler, Lucy
dc.contributor.authorMulvey, M.
dc.contributor.authorBlenkinsopp, Alison
dc.contributor.authorPetty, Duncan R.
dc.contributor.authorBennett, M.I.
dc.date.accessioned2016-11-23T16:55:08Z
dc.date.available2016-11-23T16:55:08Z
dc.date.issued2015-11
dc.identifier.citationZiegler L, Mulvey M, Blenkinsopp A, Petty DR, Bennett MI (2016) Opioid prescribing for cancer patients in the last year of life: a longitudinal population cohort study. Pain. 157(11): 2445-2451.en_US
dc.identifier.urihttp://hdl.handle.net/10454/10495
dc.descriptionYesen_US
dc.description.abstractWe linked UK cancer registry data with the corresponding electronic primary care medical records of 6080 patients who died of cancer over a 7-year period in a large United Kingdom city. We extracted all prescriptions for analgesics issued to each patient in the linked cohort during the 12 months before death and analysed the extent and duration of strong opioid treatment with clinical and patient characteristics. Strong opioids were prescribed for 48% of patients in the last year of life. Median interval between first prescription of a strong opioid and death was 9 weeks (interquartile range 3-23). Strong opioid prescribing was not influenced by cancer type, duration of illness, or gender but was adversely influenced by older age. Compared with patients who died in a hospice, those who died in a hospital were 60% less likely to receive a strong opioid in primary care before admission (relative risk ratio 0.4, CI 0.3-0.5, P < 0.01). The study provides the first detailed analysis of the relatively late onset and short duration of strong opioid treatment in patients with cancer before death in a representative UK cohort. This pattern of prescribing does not match epidemiological data which point to earlier onset of pain. Although persistent undertreatment of cancer pain is well documented, this study suggests that strategies for earlier pain assessment and initiation of strong opioid treatment in community-based patients with cancer could help to improve pain outcomes.en_US
dc.description.sponsorshipNational Institute for Health Research (NIHR) (RP-PG-0610-10114)en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttp://dx.doi.org/10.1097/j.pain.0000000000000656en_US
dc.rights© 2016 International Association for the Study of Pain. Full-text reproduced in accordance with the publisher’s self-archiving policy.en_US
dc.subjectOpioids; Cancer pain; Palliative careen_US
dc.titleOpioid prescribing for cancer patients in the last year of life: a longitudinal population cohort studyen_US
dc.status.refereedYesen_US
dc.date.Accepted2016
dc.typeArticleen_US
dc.type.versionAccepted Manuscripten_US
refterms.dateFOA2018-07-26T09:37:06Z


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