Wei-Hung Hsu1, Jyh-Gang Hsieh1, Ying-Wei Wang1, Chia-Jung Hsieh2, Huang-Ren Lin3, Szu-Yuan Wu4,5,6,7,8,9,10. 1. Department of Family Medicine, Buddhist Tzu Chi General Hospital Hualien 97002, Taiwan. 2. Department of Public Health, Tzu Chi University Hualien 97004, Taiwan. 3. Department of Family Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital Yilan 265, Taiwan. 4. Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University Taichung 41354, Taiwan. 5. Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital Yilan 265, Taiwan. 6. Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital Yilan 265, Taiwan. 7. Department of Healthcare Administration, College of Medical and Health Science, Asia University Taichung 41354, Taiwan. 8. Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital Yilan 265, Taiwan. 9. Graduate Institute of Business Administration, Fu Jen Catholic University Taipei 242062, Taiwan. 10. Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University Taipei 110, Taiwan.
Abstract
PURPOSE: To estimate differences in pain control between patients with cancer and with or without dementia during terminal cancer stages 3 months or 1 month before cancer death. PATIENTS AND METHODS: We conducted frequency matching cohort for age, sex, and year of death for both groups at a 1:4 ratio. The prescription prevalence, total cumulative dose, and average daily dose of opioids during the terminal cancer stages 3 months and 1 month before cancer death were estimated. RESULTS: Patients with cancer and dementia were prescribed lower amounts of opioids 3 months before death (57.5% vs. 73.9%, respectively; adjusted odds ratio [OR] 0.46; 95% confidence interval [CI] 0.44-0.49) and 1 month before death (54.4% vs. 70.3%, respectively; adjusted OR 0.50; 95% CI 0.47-0.53). The total cumulative dose of opioids (mg) was lower in patients with cancer and dementia 3 and 1 month(s) before death (3 months: 1,578 mg vs. 2,666 mg, respectively; β=-1,125.9, P<0.001; 1 month: 921 mg vs. 1,533 mg, respectively; β=-622.1, P<0.001). The average daily opioid dose (mg/day), patients with cancer and dementia received a lower dose 3 months before death (31 mg vs. 48 mg; β=-22.6, P<0.001) and 1 month before death (38 mg vs. 60 mg; β=-17.1, P<0.001). CONCLUSION: The prevalence of opioid prescription was significantly lower in patients with both cancer and dementia during their terminal cancer stages 3 months and 1 month before death. AJTR
PURPOSE: To estimate differences in pain control between patients with cancer and with or without dementia during terminal cancer stages 3 months or 1 month before cancer death. PATIENTS AND METHODS: We conducted frequency matching cohort for age, sex, and year of death for both groups at a 1:4 ratio. The prescription prevalence, total cumulative dose, and average daily dose of opioids during the terminal cancer stages 3 months and 1 month before cancer death were estimated. RESULTS: Patients with cancer and dementia were prescribed lower amounts of opioids 3 months before death (57.5% vs. 73.9%, respectively; adjusted odds ratio [OR] 0.46; 95% confidence interval [CI] 0.44-0.49) and 1 month before death (54.4% vs. 70.3%, respectively; adjusted OR 0.50; 95% CI 0.47-0.53). The total cumulative dose of opioids (mg) was lower in patients with cancer and dementia 3 and 1 month(s) before death (3 months: 1,578 mg vs. 2,666 mg, respectively; β=-1,125.9, P<0.001; 1 month: 921 mg vs. 1,533 mg, respectively; β=-622.1, P<0.001). The average daily opioid dose (mg/day), patients with cancer and dementia received a lower dose 3 months before death (31 mg vs. 48 mg; β=-22.6, P<0.001) and 1 month before death (38 mg vs. 60 mg; β=-17.1, P<0.001). CONCLUSION: The prevalence of opioid prescription was significantly lower in patients with both cancer and dementia during their terminal cancer stages 3 months and 1 month before death. AJTR
Authors: Jiaqiang Zhang; Lei Qin; Ho-Min Chen; Han-Chuan Hsu; Chih-Chi Chuang; Dar Chen; Szu-Yuan Wu Journal: Am J Cancer Res Date: 2020-06-01 Impact factor: 6.166