Palliative Medicine Reports (Sep 2021)

Factors Associated with Cancer-Related Pain Requiring High-Dose Opioid Use in Palliative Cancer Patients

  • Hidetoshi Sumimoto,
  • Komaki Hayashi,
  • Yuri Kimura,
  • Akihito Nishikawa,
  • Seiko Hattori,
  • Chiaki Hasegawa,
  • Hiroaki Morii,
  • Koji Teramoto,
  • Sachiyo Morita,
  • Yataro Daigo

DOI
https://doi.org/10.1089/PMR.2021.0037
Journal volume & issue
Vol. 2, no. 1
pp. 237 – 241

Abstract

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Background: There are no universal tools to predict the necessity of high-dose opioid use for cancer-related pain. Early recognition and interventions for intractable cancer pain could minimize the distress of palliative patients. Objective: We sought to identify the clinical factors associated with high-dose opioid use in advanced cancer patients to recognize palliative patients who would develop intractable cancer pain, as early as possible. Setting/Subjects: Among 385 in-hospital cancer patients from April 1, 2014 to July 31, 2019, who were referred to the palliative care team for cancer-related pain, clinical factors significantly correlated to high-dose opioid use were retrospectively analyzed. Measurements: We conducted a multiple logistic regression analysis to identify variables significantly related to high-dose opioid use (>120?mg/day oral morphine equivalent dose). Results: Independent factors of high-dose opioid use included younger age (odds ratio [OR] 0.965, 95% confidence interval [CI] 0.944?0.986, p?=?0.001), respiratory cancers (OR 1.882, 95% CI 1.069?3.312, p?<?0.001), and opioid switch (OR 2.869, 95% CI 1.497?5.497, p?=?0.001). The percentage of correct classifications of the regression equation was 86.9%. Conclusions: Younger age, respiratory cancers, and opioid switch were related to high-dose opioid use. Our findings may help palliative caregivers to deal with intractable cancer pain in palliative patients, and thus relieve their distress.

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