OBJECTIVE: To find the pattern of use of opiate drugs for treating pain in terminal cancer patients. DESIGN: Retrospective descriptive study. SETTING: Gavà 2 Health Centre, located in Barcelona's industrial belt. MATERIAL AND METHOD: Systematic review of the clinical records for the deaths recorded between May 1993 and March 1998. The following variables were recorded: age, sex, cause and place of death, professional attending patient during terminal phase, use of opiates (type, how they were taken, dosage and length of treatment) and prescribing doctor. RESULTS: Of the 429 deaths reviewed, 100 (23%) were caused by neoplasm (68% males), with an average age of 69 +/- 3 years. More than half the patients (55%) died at home. In the terminal phase they were mainly attended (69%) by their Primary Care team. 52% of the patients were given opiates, with morphine being the most common (71.1%), followed by codeine (40.3%) and tramadol (17.3%). The general practitioner was the prescribing agent in 69.2% of the cases. 76% of the patients who took codeine did so at infra-therapeutic doses (< 120 mg per day). Similarly, insufficient doses of morphine (< 60 mg per day) were given to half the patients who received it. 21.62% only took it during a period of 5 days or less before death. CONCLUSIONS: Primary care teams are taking on steadily greater protagonism in caring for terminal cancer patients. Although a large number of these patients are treated with opiates, these are given at often insufficient doses and for too short time periods.
OBJECTIVE: To find the pattern of use of opiate drugs for treating pain in terminal cancerpatients. DESIGN: Retrospective descriptive study. SETTING: Gavà 2 Health Centre, located in Barcelona's industrial belt. MATERIAL AND METHOD: Systematic review of the clinical records for the deaths recorded between May 1993 and March 1998. The following variables were recorded: age, sex, cause and place of death, professional attending patient during terminal phase, use of opiates (type, how they were taken, dosage and length of treatment) and prescribing doctor. RESULTS: Of the 429 deaths reviewed, 100 (23%) were caused by neoplasm (68% males), with an average age of 69 +/- 3 years. More than half the patients (55%) died at home. In the terminal phase they were mainly attended (69%) by their Primary Care team. 52% of the patients were given opiates, with morphine being the most common (71.1%), followed by codeine (40.3%) and tramadol (17.3%). The general practitioner was the prescribing agent in 69.2% of the cases. 76% of the patients who took codeine did so at infra-therapeutic doses (< 120 mg per day). Similarly, insufficient doses of morphine (< 60 mg per day) were given to half the patients who received it. 21.62% only took it during a period of 5 days or less before death. CONCLUSIONS: Primary care teams are taking on steadily greater protagonism in caring for terminal cancerpatients. Although a large number of these patients are treated with opiates, these are given at often insufficient doses and for too short time periods.
Authors: E Escortell-Mayor; O Larrubia-Muñoz; D Troncoso-Viejo; R Martínez-Martínez; A López-Romero; C de Miguel-Sánchez Journal: Aten Primaria Date: 2006-02-15 Impact factor: 1.137