TY - JOUR
T1 - Opioid prescription trends among patients with cancer referred to outpatient palliative care over a 6-year period
AU - Haider, Ali
AU - Zhukovsky, Donna S.
AU - Meng, Yee Choon
AU - Baidoo, Joseph
AU - Tanco, Kimberson C.
AU - Stewart, Holly A.
AU - Edwards, Tonya
AU - Joy, Manju P.
AU - Kuriakose, Leela
AU - Lu, Zhanni
AU - Williams, Janet L.
AU - Liu, Diane D.
AU - Bruera, Eduardo
N1 - Publisher Copyright:
Copyright © 2018 American Society of Clinical Oncology. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - Introduction In the United States, opioid regulations have becomeincreasingly stringent in recent years. Increased regulatory scrutiny, in part, is related to heightened awareness through literature and a recent media blitz on the opioid prescription epidemic. These regulations have the potential to impact prescription trends by health care providers. Our objective was to evaluate changes in the type and dose of opioid prescriptions among patients who are referred by oncologists to an outpatient palliative care clinic. Materials and Methods We reviewed the electronic health records of 750 patients who were seen as new consultations at MD Anderson Cancer Center's outpatient palliative care clinic between January 1 and April 30 each year from 2010 through 2015. Data collected included demographics, cancer type and stage, symptom assessment, performance status, opioid type, and opioid dose defined as the morphine equivalent daily dose (MEDD). Results Median age was 59 years (interquartile range [IQR], 51 to 67), 383 (51%) were female, 529 (70%) were white, and 654 (87%)of patients had advanced cancer. In 2010, medianMEDD before referral was 78 mg/d (IQR, 30 to 150); however, by 2015, the MEDD had progressively decreased to 40 mg/d (IQR, 19 to 80; P = .001). Hydrocodone was the most common opioid prescribed between 2010 and 2015; however, after its reclassification as a schedule II opioid in October 2014, the use of tramadol, a schedule IV opioid, increased (P <.001). Conclusion During the past several years, the MEDD prescribed by referring oncologists has decreased. After hydrocodone reclassification, the use of tramadol with less stringent prescription limits has increased.
AB - Introduction In the United States, opioid regulations have becomeincreasingly stringent in recent years. Increased regulatory scrutiny, in part, is related to heightened awareness through literature and a recent media blitz on the opioid prescription epidemic. These regulations have the potential to impact prescription trends by health care providers. Our objective was to evaluate changes in the type and dose of opioid prescriptions among patients who are referred by oncologists to an outpatient palliative care clinic. Materials and Methods We reviewed the electronic health records of 750 patients who were seen as new consultations at MD Anderson Cancer Center's outpatient palliative care clinic between January 1 and April 30 each year from 2010 through 2015. Data collected included demographics, cancer type and stage, symptom assessment, performance status, opioid type, and opioid dose defined as the morphine equivalent daily dose (MEDD). Results Median age was 59 years (interquartile range [IQR], 51 to 67), 383 (51%) were female, 529 (70%) were white, and 654 (87%)of patients had advanced cancer. In 2010, medianMEDD before referral was 78 mg/d (IQR, 30 to 150); however, by 2015, the MEDD had progressively decreased to 40 mg/d (IQR, 19 to 80; P = .001). Hydrocodone was the most common opioid prescribed between 2010 and 2015; however, after its reclassification as a schedule II opioid in October 2014, the use of tramadol, a schedule IV opioid, increased (P <.001). Conclusion During the past several years, the MEDD prescribed by referring oncologists has decreased. After hydrocodone reclassification, the use of tramadol with less stringent prescription limits has increased.
UR - http://www.scopus.com/inward/record.url?scp=85039935427&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039935427&partnerID=8YFLogxK
U2 - 10.1200/JOP.2017.024901
DO - 10.1200/JOP.2017.024901
M3 - Review article
C2 - 29028417
AN - SCOPUS:85039935427
SN - 1554-7477
VL - 13
SP - e972-e981
JO - Journal of oncology practice
JF - Journal of oncology practice
IS - 12
ER -