Opioid Shortage Influences How Cancer-Related Pain Is Managed by Inpatient Palliative Care Team

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Changes in pain management due to parenteral opioid shortage has initial negative effect, then stabilizes.
Changes in pain management due to parenteral opioid shortage has initial negative effect, then stabilizes.
The following article features coverage from the 2018 Palliative Care in Oncology Symposium meeting. Click here to read more of Oncology Nurse Advisor's conference coverage.

Changes in opioid administration due to a parenteral opioid shortage, announced on February 8, 2018, resulted in consequences for management of cancer-related pain, according to study results reported at the 2018 Palliative and Supportive Care in Oncology Symposium.

The research team examined the electronic health records of 386 patient visits from an inpatient palliative care team at 1 month before and 1 month after the announcement of the parenteral opioid shortage.

The researchers evaluated opioid type, dosage, and administration, as well as patient demographics and type of cancer. The 193 eligible patients with cancer were aged 18 or older, had 2 or more visits with the inpatient palliative care team, and were treated with an opioid at the time of consultation.

Parenteral opioids included intravenous breakthrough treatment and patient-controlled analgesia. Nonparenteral options included transdermal, extended release, and oral breakthrough treatments.

Overall, the shortage of parenteral opioids was correlated with relatively more reliance on nonparenteral opioids by both palliative care and referring oncology teams (P <.001 for each).

Pain control was less effective at the first follow-up with the palliative care team following the announcement of the shortage (62%) vs before the shortage (75%; P =.006), but by the second follow-up the preannouncement and postannouncement cohorts showed more similar levels of pain control.

The authors concluded that the parenteral opioid shortage had a significant effect on administration of opioids to patients for treatment of cancer-related pain and that this is linked with overall poorer analgesia.

Reference

Haider A, Qian Y, Lu Z, et al. Impact of parenteral opioid shortage on opioid prescriptions among patients seen by the palliative care team of a comprehensive cancer center. J Clin Oncol. 2018;36(suppl 34). Abstract 201.

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