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Opioid consumption by cancer patients in an in-patient hospice — a retrospective study

Bartosz Kędziora12, Joanna Tabak23, Barbara Komsta4, Karolina Osowiecka5, Monika Rucińska46

Abstract

Introduction. Opioids are essential in relieving moderate to severe pain in patients in palliative care. This study aimed to assess daily opioid consumption in cancer patients hospitalized in an in-patient hospice from admission to the end of their stay. 

Material and methods. This retrospective, single-center study was performed in a Hospice in Olsztyn. The total amount of daily opioid intake was studied at three time points: on the second, seventh day, and penultimate days of patients’ stay in the stationary hospice. The doses of various opioids were converted to an equivalent dose of oral morphine in milligrams [morphine equivalent daily dose (MEDD)]. 

Results. Forty-two percent of patients started their stay at the stationary hospice without opioid drugs. There was a significant difference in MEDD between the second day (53.31 mg) and penultimate day (80.96 mg) of stay for 72 patients (we excluded patients, who had lived fewer than 4 days) (p < 0.001). Among the 60 patients (excluding patients who lived fewer than 8 days) MEDD increased from the second (44.47 mg) to the seventh day (68.02 mg) (p < 0.01), and then the dose slightly decreased on the penultimate day of their stay (63.15 mg) (p = 0.04). In the case of patients who started hospitalization without opioids, MEDD on the seventh day was 14.29 mg (p < 0.01) and 28.57 mg on the penultimate day (p < 0.001). A significant negative linear correlation between MEDD and age was shown. 

Conclusions. Opioid consumption increased during patients’ stay at in-patient hospice. Younger patients needed higher doses of opioids.

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