Opioid Prescribing Patterns Before and After an Inpatient Palliative Care Consultation.

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Opioid Prescribing Patterns Before and After an Inpatient Palliative Care Consultation.

Am J Hosp Palliat Care. 2019 Dec 26;:1049909119897260

Authors: Al-Shahri MZ, Abdullah A, Alansari A, Sroor M

Abstract
BACKGROUND: To the best of our knowledge, the change in opioid prescription patterns upon referral to a palliative care team (PCT) was not previously investigated in the Middle East.
OBJECTIVE: This study aimed to explore the change in the pattern of opioid prescription and the pain scores before and after referring inpatients to a PCT.
METHODS: We conducted a retrospective review of patients' records including all inpatients ≥15 years newly referred to the PCT over a period of 21 months at King Faisal Specialist Hospital and Research Center, Riyadh.
RESULTS: Of 631 patients, 52.3% were females, the median age was 54 years, and 96.7% had cancer. The proportion of patients on opioids before referral (83.4%) increased to 93.3% in the postreferral period, P < .0001. Patients receiving opioids on a regular basis increased from 31.9% before referral to 49.9% after referral to the PCT, P < .0001. Morphine was the most commonly prescribed opioid on a regular basis pre- and postreferral. Upon referral, the administration of opioids through the subcutaneous route increased from 3.7% to 10.9%, P < .0001. On average, pain scores were reduced by 1 point on a 0 to 10 numeric scale within 48 hours of seeing a patient by the PCT, P < .0001.
CONCLUSION: Patients referred to a PCT are likely to get their opioid prescription optimized and pain scores improved shortly after the PCT involvement. Patients with cancer-related pain requiring opioids should be referred to a PCT as early as possible.

PMID: 31876160 [PubMed - as supplied by publisher]

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