Insufficient Pain Control for Patients with Cancer and Dementia During Terminal Cancer Stages

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2021 Dec 27

PMID 34956521

Citations 1

Authors

Wei-Hung Hsu

Jyh-Gang Hsieh

Ying-Wei Wang

Chia-Jung Hsieh

Huang-Ren Lin

Szu-Yuan Wu

Affiliations

Soon will be listed here.

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, <0.001; 1 month: 921 mg vs. 1,533 mg, respectively; β=-622.1, <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, <0.001) and 1 month before death (38 mg vs. 60 mg; β=-17.1, <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.

Citing Articles

Good Death and Quality of End-of-Life Care in Patients with Coexisting Cancer and Dementia: Perspective of Bereaved Families.

Takao A, Arao H, Yamamoto S, Aoki M, Kouda K, Morita T Palliat Med Rep. 2024; 5(1):215-224.

PMID: 39044761 PMC: 11262574. DOI: 10.1089/pmr.2023.0083.

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